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Drug Allergies
Janet Beausoleil, MD, is an assistant professor of pediatrics at the University of Pennsylvania School of Medicine, and board certified in pediatrics and allergy and immunology, and has a special interest in allergic disorders. Here she discusses adverse drug reactions, drug hypersensitivity, penicillin allergy, and non-IgE mediated reactions, including those to immunoglobulin-mediated cytotoxins. Dr. Beausoleil wishes to disclosure that she has appeared as a speaker for GlaxoSmithKline and Merck. Dr. Beausoleil says that adverse drug reactions (ADRs) account for between 75,000 and 106,000 deaths annually. She describes the two main types of ADr. – one common and predictable, the other less common and unpredictable – and provides examples of each. Noting the importance of a rigorous history, she goes on to describe how Ig-E mediated drug hypersensitivity manifests itself, and advises that desensitizing patients for this should be performed only by physicians experienced in allergy testing and the treatment of anaphylaxis. Using clear graphics, she explains several types of non-IgE mediated reactions and their symptoms. She further discusses the major determinants of penicillin allergy and warns that almost all fatal penicillin reactions begin within one hour of administration. She notes, however, that prudent use of pharmacologic agents is important in preventing ADRs. Dr. Beausoleil touches upon cross-reactions of cephalosporins with penicillin. She concludes this lecture with a discussion of cytotoxic reactions (which can be life threatening), immune complex, cell-mediated and pseudolallergic reactions ... and reactions to NSAIDs. |
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