title: Trends in hypersensitivity drug reactions: more drugs, more response patterns, more heterogeneity.
abstract: Hypersensitivity drug reactions (HDRs) vary over time in frequency, drugs involved, and clinical entities. Specific reactions are mediated by IgE, other antibody isotypes (IgG or IgM), and T cells. Nonspecific HDRs include those caused by nonsteroidal anti-inflammatory drugs (NSAIDs). beta-Lactams--the most important of which are amoxicillin and clavulanic acid--are involved in specific immunological mechanisms. Fluoroquinolones (mainly moxifloxacin, followed by ciprofloxacin and levofloxacin) can also induce HDRs mediated by IgE and T cells. In the case of radio contrast media, immediate reactions have decreased, while nonimmediate reactions, mediated by T cells, have increased. There has been a substantial rise in hypersensitivity reactions to antibiotics and latex in perioperative allergic reactions to anesthetics. NSAIDs are the most frequent drugs involved in HDRs. Five well-defined clinical entities, the most common of which is NSAID-induced urticaria/angioedema, have been proposed in a new consensus classification. Biological agents are proteins including antibodies that have been humanized in order to avoid adverse reactions. Reactions can be mediated by IgE or T cells or they may be due to an immunological imbalance. Chimeric antibodies are still in use and may have epitopes that are recognized by the immune system, resulting in allergic reactions.
authors.forename: I
authors.initials: I
authors.lastname: Doña
authors.forename: E
authors.initials: E
authors.lastname: Barrionuevo
authors.forename: N
authors.initials: N
authors.lastname: Blanca-Lopez
authors.forename: M J
authors.initials: MJ
authors.lastname: Torres
authors.forename: T D
authors.initials: TD
authors.lastname: Fernandez
authors.forename: C
authors.initials: C
authors.lastname: Mayorga
authors.forename: G
authors.initials: G
authors.lastname: Canto
authors.forename: M
authors.initials: M
authors.lastname: Blanca
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001685:Biological Factors / Q000009:adverse effects; D003287:Contrast Media / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents; D001685:Biological Factors; D003287:Contrast Media; D009466:Neuromuscular Blocking Agents; D007073:Immunoglobulin E