What are Drug Allergies

Common Drug Allergy Symptoms

  • Skin rash or hives or angioedema
  • Oral or genital ulcers
  • Itching
  • Wheezing or other breathing problems
  • Swelling
  • Anaphylaxis, a potentially life-threatening reaction that can simultaneously affect two or more organ systems (for example, when there is both a rash and difficulty breathing)

Managing Drug Allergies

  • Antibiotics e.g penicillin, cephalosporins and sulfonamides (sulfa drugs)
  • Anticonvulsants
  • Aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Paracetamol
  • Chemotherapy drugs

The history is the most important in diagnosis of drug allergy. Your physician will want to know the answers to these questions:

  • What drug was taken?
  • When did you start taking it, and have you stopped taking it?
  • How long after you took the drug did you notice symptoms, and what did you experience?
  • How long did your symptoms last, and what did you do to relieve them?
  • What other medications were taken at the same time?
  • Do you consume herbal medications or take vitamin or mineral supplements? If so, which ones?

Your doctor will also want to know whether you have had a reaction to any other drug. If you can, bring the suspected drug with you. This will help the doctor recommend alternatives as needed.

During a physical examination, your doctor will look for problems that are part of the drug reaction, along with non-allergic reasons for the reaction.

Depending on the drug suspected of causing the reaction, your allergist may suggest a skin test or, in limited instances, a blood test.

If a drug allergy is suspected, your allergist may also recommend an oral drug challenge, in which you will be supervised by medical staff as you take the drug suspected of triggering a reaction. (If your reaction was severe, a drug challenge may be considered too dangerous.)

  • Avoid triggers.
  • Take antihistamines to control some symptoms.
  • Seek immediate medical care if symptoms worsen or multiple symptoms occur together (anaphylaxis).
  • In cases where alternative drugs can be advised for the patients who need the medications for management of their infection or illness.

Non-Steroidal Anti-inflammatory drugs and Paracetamol Intolerance

Non-Steroidal Anti-inflammatory drugs (NSAIDs) allergy such as paracetamol and ibuprofen can be commonly observed in children and adults in Singapore. Although the reaction is usually eye swelling and hives when exposed to these drugs, there have been instances of wheezing and anaphylaxis to some NSAIDs. The hypersensitivity to NSAIDs drugs and Paracetamol appears to occur after they have been consuming these medication for the past few months or years without prior problems. These reactions are more biochemical rather than allergic. It is best to avoid the whole class of NSAID. The opiate group of painkillers may be used. The other option is the COX-2 inhibitor. However, COX-2 inhibitor should only be prescribed after a drug provocation test as there is a 5% percent chance of cross-reactivity between COX-2 inhibitor and traditional NSIAD.

Drug desensitization

If there is no suitable alternative to the antibiotic that you are allergic to, you will need to undergo drug desensitization. This involves taking the drug in increasing amounts until you can tolerate the needed dose with minimal side effects. This will most likely be done in a hospital so immediate medical care is available if problems develop. Desensitization can help only if you are taking the drug every day. Once you stop it - for example, when a chemotherapy or antibiotic cycle ends - you will need to go through desensitization a second time if you need the drug again.

Living with Drug Allergies

People with drug allergies may experience symptoms regardless of whether their medicine comes in liquid, pill or injectable form. While you may not experience allergic symptoms the first time you take a drug, your body could be producing antibodies to it. As a result, the next time you take the drug, your immune system may see it as an invader, and you’ll develop symptoms as your body releases chemicals to defend against it. The time of a drug reaction varies from person to person. Some people may react right away between 1-2 hours, while others might take several days before they have an allergic reaction; especially if this is the first time the person take the drugs.

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