Drug Allergy

Editor: V. Dimov, M.D., Allergist/Immunologist and Assistant Professor at University of Chicago

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.

Information For Patients

Medications and Drug Allergic Reactions
Allergy Testing

Allergic Reactions
Hives (urticaria) and angioedema
Contact dermatitis

Classification of adverse reactions to drugs, using the "SOAP III" mnemonic (click to enlarge the image).

What to expect when visiting an allergy clinic

Current allergy skin tests are virtually painless. This video by Dr. Bassett, a board-certified allergist from New York City, shows what to expect when visiting an allergy clinic for diagnosis and treatment:

Information For Doctors

Drug Hypersensitivity: Teaching Cases

Drug-related Rash Caused by Levofloxacin
Angioedema Due to Angiotensin Converting Enzyme Inhibitors
Adverse reaction with local anesthetic - how to rule out allergy?
Suspected allergic reaction to adalimumab (Humira): what to do?
Penicillin desensitization in a patient with history of anaphylaxis to penicillin
Patient with Arthritis and Hypersensitivity to Nonsteroidal Antiinflammatory Drugs (NSAIDs)
Anaphylactoid Reaction to Intravenous Contrast
Suspected progesterone allergy
Pruritus secondary to opioids without evidence of allergic reaction after a graded drug challenge with oxycodone
An "Allergic Rash" Which Turned Out to be Seborrheic Dermatitis
It's not a drug reaction but a fungal infection in an immunosuppressed patient (tinea corporis)
"Pseudoallergic reaction" to albuterol
Correct diagnosis is keratosis pilaris rather than an "allergic rash"
Facial angioedema after dental work - how to rule out latex allergy?
How to rule out suspected allergy to Diphtheria Toxoid and Acellular Pertussis (Tdap) vaccine?
Acute urticaria (hives) due to allergy to terbinafine
Blue Hives. NEJM Images in Clinical Medicine, 02/2008.Fixed Drug Eruption. NEJM, 08/2011.
Delayed allergic reactions to omalizumab: Are patients reporting all cases? JACI, 03/2008.

Related Reading

Adverse Reactions to Drugs: Brief Review
Mind Maps: Drug Allergy
Mnemonics: Drug Allergy
Blog articles from AllergyNotes
Skin test procedures in the diagnosis of drug hypersensitivity. Brockow et al, 2002, Allergy.
Poison Pill: Allergic Reaction to Quinine. NYTimes, 04/2008.
Drug Allergies - 2014 summary from Allergic Diseases Resource Center from World Allergy Organization http://buff.ly/1gbXRY5

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.

Image source: Wikipedia, GNU Free Documentation License.

Published: 07/01/2007
Updated: 03/10/2014

No comments: