Author: V. Dimov, M.D., Allergist/Immunologist and Assistant Professor at University of Chicago
Reviewer: S. Randhawa, M.D., Allergist/Immunologist
When drug reactions resembling allergy happen, they are called drug hypersensitivity reactions (DHRs). Drug hypersensitivity reactions may be allergic or nonallergic. Drug allergies are drug hypersensitivity reactions caused by the immune system.
Classification of adverse reactions to drugs: "SOAP III" mnemonic (click to enlarge the image):
Adverse drug reactions (ADRs) affect 10–20% of hospitalized patients and 25% of outpatients.
Rule of 10s in ADR
10% of patients develop ADR
10% of these are due to allergy
10% of these lead to anaphylaxis
10% of these lead to death
Adverse reactions to drugs (click to enlarge the image).
Classification of adverse reactions to drugs (click to enlarge the image).
Clinical manifestations of drug reactions (click to enlarge the image).
Skin reactions to drugs (click to enlarge the image).
Hypersensitivity reactions to beta-lactam antibiotics: MAUS mnemonic 20-20-40-20%. Click here to enlarge the image.
Management of adverse drug reactions: APD or PAD (click to enlarge the image).
Number of patients with drug allergy before and after allergologic study (figure) http://goo.gl/vva0Y and JACI, 2012.
Multiple choice questions
Chapter 57: Drug Allergy. Allergy and Immunology Review Corner: Chapter 57 of Pediatric Allergy: Principles & Practices, edited by Donald Y.M. Leung, et al.