title: Drug allergies.
abstract: Allergic drug reactions are a significant cause of morbidity and mortality. Because it is difficult to identify the culprit drug and the underlying pathophysiologic mechanisms involved in these reactions, a systematic approach should be adopted in the evaluation of drug-allergic patients. Initially, the type of reaction should be determined. It should be realized that not all adverse reactions are allergic in nature. Allergic drug reactions comprise only a small category of adverse reactions in general. Therefore, the physician must determine if the reaction demonstrates features common to immunologic reaction. Subsequently, a detailed history should be obtained and a physical should be performed. Important information includes medication usage, previous drug exposure, current illness, family history of drug allergy and personal history of drug allergy. In managing the drug-allergic patient, the physician may choose to: select an alternative, non-cross-reacting drug if future therapy is needed; premedicate prior to future drug exposure if such regimens have been shown to be effective; or consult an allergist regarding the potential graded challenge or desensitization.
authors.affiliation: Division of Allergy and Immunology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-8859, USA. rgruch@mednet.swmed.edu
authors.forename: R S
authors.initials: RS
authors.lastname: Gruchalla
mesh_terms: D004342:Drug Hypersensitivity / Q000145:classification / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D012307:Risk Factors
chemical_list: D007073:Immunoglobulin E