Allergic reactions to drugs and biologic agents.

Full Abstract

In summary, the term adverse drug reaction is used to designate any type of undesirable and unintended response to a drug and can be broadly classified on the basis of either the presence or absence of an immune mechanism. Allergic reactions (immune) constitute only 5% to 10% of adverse drug reactions. Drug intolerance (nonimmune) constitutes the rest of these reactions. Many of these latter reactions are mild and self-limited, and many drug intolerances cannot be exactly characterized. Of those reactions in which an immune mechanism has been indicated or reactions that clinically appear to be "allergiclike," a limited number of in vivo (eg, skin tests) or in vitro (eg, RAST, IgE-ELISA, other antibody, or cell-mediated assays) tests have proved helpful in the diagnosis. Best studied are adverse reactions to aspirin, penicillin, insulin, and RCM. The principal treatment of all adverse drug reactions is to avoid the drug that has been specifically identified as being responsible for the previous reaction. In cases where avoidance is not possible, desensitization is an alternative (eg, penicillin and insulin). Prophylactic treatment of patients who had previously demonstrated a drug intolerance reaction (eg, systemic RCM reaction) with medication--particularly type I activation--may be helpful in some patients.

Author information

Author/s: Anderson, J A (JA); Adkinson, N F (NF);

Journal and publication information

Publication Type: Journal Article; Review

Journal: JAMA : the journal of the American Medical Association (JAMA), published in UNITED STATES. (Language: eng)

Reference: 1987-Nov; vol 258 (issue 20) : pp 2891-9

Dates: Created 1987/12/17; Completed 1987/12/17; Revised 2006/11/07;

PMID: 3312672, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Anesthetics - adverse effects
Anti-Bacterial Agents - adverse effects
Aspirin - adverse effects
Biological Products - adverse effects
Chymopapain - adverse effects
Contrast Media - adverse effects

Contrast Media - adverse effects
Drug Hypersensitivity - classification; diagnosis; immunology; therapy
Humans
Insulin - adverse effects
Lactams
Vaccines - adverse effects

Associated Chemicals: Anesthetics (0) ; Anti-Bacterial Agents (0) ; Biological Products (0) ; Contrast Media (0) ; Lactams (0) ; Vaccines (0) ; Insulin (11061-68-0) ; Aspirin (50-78-2) ; Chymopapain (EC 3.4.22.6)

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