drug allergy. Allergy to drugs: causes, symptoms and treatment What to do if you are allergic to drugs

Drug allergy is a pathological reaction to pharmacological drugs that are taken at the usual recommended dose. This disease can be caused not only by the active substance in the drug, but also by the so-called auxiliary agents (lactose, preservatives, etc.).

How does the reaction develop? After the first injection (oral, enteral or intravenous), the immune system "remembers" the allergen and begins to create antibodies against it. The symptoms themselves develop after the drug has already accumulated in the blood (this can happen after the second, third or tenth dose - it all depends on the degree of sensitivity of the body).

Drug allergies are a serious problem. Currently, there are thousands of drugs on the market that can be bought without a prescription not only in pharmacies, but also in a store, kiosk or gas station. Easy access to medicines and increased frequency of their use has resulted in about 6-10 percent of the population suffering from this type of allergy.

Of course, treatment should begin with the complete abolition of the aggressive substance. Next, you need to take drugs that block the production of histamine. It is better that these are natural drugs - then you will definitely be sure that the body will perceive them well, and the disease will not worsen. Stop poisoning yourself with chemistry, because almost any ailment can be eliminated by improvised methods and a healthy lifestyle!

The causes of drug sensitization are still poorly understood. However, it is known that this is influenced by a number of factors:

patient's genetic susceptibility;
frequent and prolonged pharmacotherapy (the more often the drug is administered, the higher the likelihood of allergies);
chronic and immune diseases;
gender and age (usually adult female patients get sick);
current state of health (allergies often occur with acute infectious diseases).

Drug allergy should be distinguished from hypersensitivity to a drug that does not involve the immune system. Symptoms of hypersensitivity may appear after the first dose of the drug, but an allergy develops to a drug that has been taken at least two times.

What medications cause allergies?

Most often, allergies occur to a protein drug, such as antisera, hormones, and antibiotics. Penicillin, which is administered by injection, can also cause serious complications in an allergic person. Sulfonamides, salicylates, iodine compounds, analgesics and drugs that are applied to the skin in the form of ointments or creams lead to increased sensitization.

People with allergies are more susceptible to allergic reactions to medications. It is worth noting that some drugs (such as tetracycline, sulfonamides, thiazides, and even St. John's wort) increase the sensitivity of the skin to sunlight, causing severe pigmentation, rashes, or blisters on the body.

Allergy to drugs is manifested by systemic reactions (anaphylaxis, serum sickness, fever) or reactions from one organ (allergic inflammation of the heart and blood vessels, an attack of bronchial asthma, allergic pneumonia, allergic rhinitis, inflammation of the liver, kidneys and skin). Allergy symptoms can also affect the hematopoietic system such as hemolytic anemia (excessive destruction of red blood cells), thrombocytopenia, and granulocytopenia.

The most common symptoms of a drug allergy are skin changes:

hives - manifested by itchy blisters and swelling (if the respiratory organs are involved, this can lead to shortness of breath or even suffocation). Such an allergy most often develops to aspirin and ampicillin (but another drug may be the culprit);
rash - occurs after taking ampicillin and sulfonamides;
erythema (reddening of the skin) is one of the most common manifestations of the disease. Red rashes are well demarcated from healthy skin, can have a different shape, be localized on the upper and lower extremities, as well as on the face. The culprits are penicillin or sulfonamides;
contact dermatitis - characterized by the presence of papules, acne and redness;
eczema of the lower leg - develops in the elderly, often accompanied by leg ulcers. Sensitizing drugs: neomycin, balsam of Peru, essential oils, propolis, ethacridine lactate, lanolin, benzocaine, detreomycin.

In addition, symptoms such as diarrhea, nausea, muscle pain, and swollen lymph nodes often develop.

An allergy to any drug will go away if you stop taking the aggressive drug. However, in severe cases, symptoms may persist for a long time. To alleviate your condition, use proven folk remedies. We divided them into several groups, depending on the medicinal properties.

Remedies for skin symptoms

As we said above, drug allergies usually produce skin symptoms. They can be quickly eliminated at home. Just remember that if bubbles (urticaria) appear on your body, they should never be torn off, burst or acted upon in other mechanical ways.

Compresses for itching, rashes and eczema

To restore the skin, you must apply compresses to the affected areas. To do this, mix 6 tablespoons of oatmeal with 3 tablespoons of cornmeal. Stir all this in 1 liter of warm water, soak gauze with the resulting liquid and apply to the skin. Warm compresses should be done several times a day.

Healing oils

To relieve unpleasant symptoms, treat with argan, sea buckthorn or almond oil. Just lubricate the skin with the selected product, and it will quickly return to its healthy state.

You can do this: mix a tablespoon of the selected oil with a teaspoon of aloe juice and shake well. Lubricate the diseased skin with this talker and leave to dry.

Tea tree oil will bring you immediate relief when you have rashes and body itching. Apply two drops of undiluted essential oil to the skin and rub into the itchy area. This treatment should be repeated 2 times a day.

Oak bark compress

Skin itching is well relieved by oak bark compresses. Boil 2 tablespoons of chopped raw materials for 10 minutes in a liter of water, then strain and leave to cool. Soak the gauze with the resulting decoction and put it in the right place (hold the compress for 15 minutes). This procedure should be done in the morning and evening until complete recovery. A decoction of oak bark can also be added to the bath if your whole body itches. Additionally, use treatment with other folk remedies.

Natural medicine recommends treating this ailment with fresh cabbage leaves. They need to be poured with warm water, and then cut a little with a knife and mashed in your hands so that the juice stands out from the plant. Attach the cabbage to the affected area, wrap with gauze and hold for at least half an hour (and preferably longer). Unpleasant itching and other skin symptoms will immediately pass.

pomegranate bark

Try also pomegranate bark treatment. This plant not only soothes allergic skin manifestations, but also normalizes the pH level of the epidermis, heals wounds, destroys bacteria.

Boil the bark of one medium pomegranate in a small amount of water (100-150 ml) to obtain a concentrated remedy. Saturate a piece of cotton wool with it and lubricate sore spots several times a day (the more often, the better). You need to do this until you are completely healed.

Remedies for swelling, muscle pain and general weakness

An allergy to a protein drug leads to swelling and aches throughout the body. What to do in this case? Of course, use our recipes.

Grass lespedeza capitate

This herb removes excess fluid, quickly relieves swelling, and helps with allergic nephritis. It is best to take an alcohol tincture of lespedeza (25 drops in the morning and evening), but if you do not have a ready-made product, you will have to make a cold extract. To do this, a handful of herbs stand overnight in a liter of cold water, and the next day they drink 100 ml 4-5 times a day.

If swelling develops quickly, there is no need to wait - mix a teaspoon of dried leaves with a teaspoon of honey and eat on an empty stomach.

Black cumin syrup

This remedy will help treat general weakness, muscle pain, swelling and fever, common problems that accompany drug allergies. It is prepared by mixing a teaspoon of cumin seeds with a teaspoon of honey and a minced clove of garlic. Take the remedy 2 times a day, 1 teaspoon.

By the way, black cumin blocks the production of histamine, so you can use it for any kind of allergy.

Violet tricolor tea

Treatment of skin inflammation, rashes, swelling and poor health is carried out with the help of tricolor violet tea. Take 1.5 teaspoons of herbs, throw in a glass of boiling water, cover with a lid. After 10 minutes, the infusion can be filtered. It is drunk 3 times a day in a glass in a heated form.

black alder leaves

Black alder is a powerful remedy for drug and any other allergies, so remedies based on it should be taken only once a day. You will need a teaspoon of crushed bark or a tablespoon of the plant's leaves. Brew them in a cup of boiling water (200 ml) and drink in the morning instead of tea. Continue treatment until complete recovery.

herbal collection

It is best to strengthen the body with the help of herbal collection. We recommend the following recipe:

Red clover flowers - 100 g;
Chamomile flowers - 100 g;
Grass orthosiphon staminate - 50 g;
Marigold flowers - 50 g;
Cumin seeds - 25 g.

To prepare the daily norm of the medicine, you will need a tablespoon of this collection. Boil herbs in a liter of water (boil for 3 minutes) and drink during the day as you feel thirsty. Continue treatment for at least a month to noticeably strengthen the body and reduce the sensitivity of the immune system.

Remedies for digestive problems

Allergy sufferers often complain of problems with the gastrointestinal tract. To restore this system, special herbs and products are needed.

Catnip

This plant will help treat not only the digestive system, but also the nervous system (and stress is a common cause of allergies). Brew 4-5 leaves in a cup of boiling water and drink instead of tea, adding raspberry or apricot jam there. Honey can only be sweetened if you are not allergic to it.

Allergic diarrhea, flatulence, nausea or vomiting will stop fresh blueberries. Grind it with sugar, and eat a teaspoon several times a day.

Oatmeal will also take care of the stomach, so you should definitely include it in your breakfast.

Dill seeds

Dill tea will bring relief within 1-2 hours after taking it. Mix a teaspoon of seeds with a glass of water, bring to a boil (or almost to a boil), and immediately turn off the heat. Drink dill water warm, without straining. If you accidentally swallow a few seeds, it's okay, it will only speed up the treatment.

lactic acid products

Dairy products contain probiotics, which seal the intestines, reducing its permeability to allergens. They will also help restore the correct balance of microflora and immunity. Every day, we recommend drinking 2 cups of natural yogurt and eating 200 g of natural curd to provide the body with such an effect.

Herbal preparations

There are many herbal preparations to eliminate unpleasant symptoms in the stomach and intestines. We will share the most effective of them:

Calendula flowers - 50 g;
Grass fume medicinal - 50 g;
Madder root - 25 g;
Dill or fennel seeds - 25 g;
Flax seeds - 25 g.

A tablespoon of the collection is kept in a thermos with a liter of boiling water (keep at least 3 hours, but you can keep it all night). The medicine is drunk before meals at regular intervals (for example, every three hours).

A collection of such herbs helps well:

Jerusalem artichoke leaves - 20 g;
Marigold flowers - 20 g;
Chamomile flowers - 20 g.

From a tablespoon of the collection, you can prepare 500 ml of cold infusion. Soak the medicine all night, and the next day drink 100 ml in 5 doses.

You can also mix the crushed capsule root with the same amount of licorice root, and make a tea (brew a teaspoon of the collection in a cup of boiling water). Don't forget to sweeten it with honey or jam!

A drug allergy is an allergic reaction caused by an individual intolerance to any component of the received drug, and not by its pharmacological action.

can develop at any age, but persons over 30 are more susceptible;
in men it is 2 times less common than in women;
often occurs in individuals with a genetic predisposition to allergies, in patients with fungal and allergic diseases;
developing during the period of treatment of the disease, contributes to its more severe course. Allergic diseases are especially difficult in this case. Even death or disability of the patient is not excluded;
can occur in healthy people who have constant professional contact with drugs (in the production of drugs and among health workers).

Distinctive features of allergic reactions:

do not resemble the pharmacological action of the drug;
do not develop upon first contact with the drug;
require prior sensitization of the body (development of hypersensitivity to the drug);
for their occurrence, a minimum amount of medication is sufficient;
reappear with each subsequent contact with the drug.

For the most part, drugs are chemical compounds that have a simpler structure than proteins.

For the immune system, such drugs are not antigens (foreign substances for the body that can cause the formation of antibodies).

Incomplete antigens (haptens) can be:

drug in unchanged form;
impurities (additional substances);
degradation products of the drug in the body.

The drug can act as an antigen, cause an allergic reaction only after certain transformations:

the formation of a form capable of binding to proteins;
connection with proteins of a given organism;
response of the immune system - the formation of antibodies.

The basis of LA is the development of the body's hypersensitivity to the resulting antigen due to the changed immune reactivity of the body.

The reaction develops mainly after the repeated intake of the drug (or its component) into the body.

Special (immune-competent) cells recognize it as a foreign substance, antigen-antibody complexes are formed, which “trigger” the development of allergies.

Few drugs are full-fledged antigens that can cause an immune response without transformations:

Factors contributing to hypersensitivity:

properties of the drug itself;
method of drug administration;
long-term use of the same drug;
combined use of drugs;
the presence of allergic diseases;
endocrine pathology;
chronic infections.

The development of sensitization is especially susceptible to patients with changes in the activity of enzymes, with pathology of the liver with a violation of its function, a violation of metabolic processes.

This explains the cases of the appearance of a reaction to the drug, which for a long period was well tolerated.

The dose of the drug that has entered the body does not affect the development of LA: it can manifest itself in some cases after inhalation of vapors of the drug or ingestion of a microscopic amount of it.

It is safer to take the medicine internally.

When applied topically, the most pronounced sensitization develops.

The most severe reactions occur with intravenous administration of drugs.

Pseudoform

There are also pseudo-allergic reactions, according to clinical manifestations, they may resemble a true allergy (anaphylactic shock).

Distinctive features of the pseudoform:

can develop already at the first contact with the drug, without requiring a period of sensitization;
immunological antigen-antibody complexes are not formed;
the occurrence of pseudo-allergy is associated with the release under the action of the resulting drug of a large amount of the biologically active substance of histamine;
the development of the reaction is facilitated by the rapid administration of the drug;
preliminary allergy tests for the drug are negative.

An indirect confirmation of the pseudoform is the absence of allergies in the past (food, drug, etc.).

To contribute to its occurrence can:

kidney and liver diseases;
metabolic disorders;
chronic infections;
excessive unreasonable receipt of medicines.

Clinical manifestations are divided into 3 groups:

acute type reactions: occur instantly or within 1 hour after the drug enters the body; these include acute urticaria, angioedema, anaphylactic shock, acute hemolytic anemia, an attack of bronchial asthma;
subacute type reactions: develop within 1 day after receiving the drug; characterized by pathological changes in the blood;
protracted reactions: develop a few days after the use of the drug; manifest in the form of serum sickness, allergic lesions of the joints, internal organs, lymph nodes.

A distinctive feature of LA is the absence of specific manifestations characteristic of a particular drug: the same symptom can appear with hypersensitivity to different drugs and the same drug can cause different clinical manifestations.

A prolonged, unmotivated fever is the only manifestation of an allergic reaction.

Skin manifestations are distinguished by polymorphism: rashes are very different (spots, nodules, blisters, vesicles, extensive reddening of the skin).

They may resemble manifestations of eczema, pink lichen, exudative diathesis.

Hives

It is manifested by the appearance of blisters, resembling a nettle burn or insect bite.

There may be a red halo around the rash element.

Blisters can merge, change dislocation.

After the disappearance of the rash does not leave marks.

May recur even without repeated use of the drug: this may be due to the presence of antibiotics in foods (for example, in meat).

Quincke's edema

Sudden painless swelling of the skin with subcutaneous tissue or mucous membranes.

Itching is not accompanied. It often develops on the face, but it can also appear on other parts of the body.

Laryngeal edema (may lead to suffocation) and cerebral edema (accompanied by headache, convulsions, delirium) are especially dangerous.

Anaphylactic shock

The most severe acute reaction to repeated drug administration.

It develops in the first or second minute after the drug enters the body (sometimes it manifests itself after 15-30 minutes).

a sharp drop in pressure;
increased and irregular heartbeats;
headache, dizziness;
chest pain;
visual impairment;
severe weakness;
abdominal pain;
impaired consciousness (up to coma);
skin manifestations (urticaria, skin edema, etc.);
cold clammy sweat;
bronchospasm with respiratory failure;
involuntary urination and defecation.

In the absence of prompt emergency care, it can end in the death of the patient.

Acute hemolytic anemia

Or "anemia" caused by the destruction of red blood cells.

weakness, dizziness;
yellowness of the sclera and skin;
enlargement of the liver and spleen;
pain in both hypochondria;
increased heart rate.

Toxidermia

It has a wide variety of manifestations of skin lesions:

spots;
nodules;
bubbles;
blisters;
petechial hemorrhages;
extensive areas of redness of the skin;
peeling, etc.

One of the reaction options is erythema on the 9th day (the appearance of patchy or widespread reddening of the skin that appears on the 9th day of the drug).

Lyell's syndrome

The most severe form of allergic lesions of the skin and mucous membranes.

It consists in necrosis (necrosis) and rejection of large areas with the formation of a sharply painful eroded surface.

May develop several hours (or weeks) after treatment.

The severity of the condition increases very quickly.

dehydration;
accession of infection with the development of infectious-toxic shock.

Mortality reaches 30-70%. Especially unfavorable outcome in children and elderly patients.

What drugs can cause a reaction

LA can develop on any drug, not excluding antiallergic drugs.

The most "dangerous" in terms of the incidence of LA are drugs:

penicillin series of antibiotics;
sulfa drugs (Biseptol, Trimethoprim, Septrin);
non-steroidal anti-inflammatory drugs (Diclofenac, Nimed, Nimesil, Aspirin, Naklofen, etc.);
B vitamins;
vaccines (usually tetanus toxoid) and serum;
immunoglobulins;
preparations containing iodine;
analgesics (painkillers);
reducing blood pressure.

Important! There is a "cross" intolerance to drugs that are similar in allergenic properties or structure: for example, between Novocain and sulfa drugs, an allergy to anti-inflammatory drugs can also appear on dyes in the yellow capsules of other drugs.

Manifestations of pseudoform often provoke:

radiopaque substances;
anesthetics (Lidocaine, Novocaine, Analgin);
anti-inflammatory drugs (Aspirin, Amidopyrine);
B vitamins;
tetracyclines;
narcotic substances;
penicillins;
sulfamides;
blood substitutes (Dextran);
antispasmodics (No-shpa, Papaverine).

Video: Antihistamines

How long after taking the drug does the reaction appear?

Manifestations of LA may develop immediately after the administration (taking) of the drug or delayed (after several hours, days, weeks), when its appearance is difficult to associate with previous treatment.

An immediate reaction with a rash can get a further response of the immune system - the development of anaphylactic shock after a while.

changes in blood composition;
temperature increase;
joint pain or arthritis;
hives;
allergic hepatitis (inflammation of the liver);
vasculitis (damage to the blood vessels);
allergic nephritis (kidney damage);
serum sickness.

During the first course of antibiotic treatment, LA may appear no earlier than 5-6 days (if there is no latent allergy), but it can also take 1-1.5 months.

At a repeated course reaction is shown at once.

Why is it important to tell doctors about your intolerance?

Considering that a reaction to the same drug can occur with repeated use, even with an interval between use of several years, a doctor of any specialty must be warned about drug intolerance.

On the cover page of the outpatient card, you should also make a note in red about the name of the drugs that cause the reaction.

The exact name (if known) of the intolerable drug must be known so that the physician can consider the possibility of cross-LA.

What are the symptoms of antibiotic allergy? The answer is here.

How to be in the treatment of teeth

About 25% of people have intolerance to painkillers, which greatly complicates the treatment of diseases requiring surgical intervention.

Problems also arise during prosthetics, removal and treatment of teeth.

Some procedures in dentistry can be tolerated by patients.

There are also alternative methods of anesthesia.

For their selection and implementation, it is necessary to consult an allergist and conduct laboratory tests.

They will help identify the anesthetic to which there is no reaction.

If there is any type of sensitization, and not just LA, it is recommended to pre-test for anesthetics, since the consequences of a developed reaction can be life-threatening.

In case of intolerance to all anesthetics (according to tests), a preliminary course of antiallergic drugs is carried out as prescribed by a doctor.

In some cases (if you need a serious dental intervention), you should choose a clinic with the possibility of general anesthesia or combined anesthesia.

Before this, you also need to consult a doctor.

It is worth noting that sensitivity to antibiotics does not mean a reaction to all medications.

How to treat this disease

When symptoms of LA appear, you should call an ambulance or consult a doctor.

In severe cases, treatment is carried out in a hospital (or even in an intensive care unit).

Treatment of drug allergies begins with drug withdrawal.

If the patient received several drugs, then all of them are stopped.

Drug therapy depends on the severity of the reaction.

With a mild degree of severity of the reaction, pills for drug allergies are prescribed, taking into account their tolerability earlier:

The doctor will give preference to drugs with a pronounced antiallergic activity and a minimum number of side effects.

Such drugs include:

If the condition does not improve, with the development of an allergic lesion of the internal organs, the doctor may prescribe a tablet or injection of glucocorticoids (Prednisolone, Dexamethasone).

In severe reactions, corticosteroids are used in large doses every 5-6 hours.

Treatment for these patients includes:

general detoxification;
restoration of electrolyte levels and acid-base balance;
maintaining hemodynamics (normal circulation).

With massive skin lesions, the patient is provided with sterile conditions.

Often, this develops or there is a threat of infection.

The choice of antibiotic is carried out taking into account the possible cross form.

The affected areas of the skin are treated:

Combination therapy includes a special diet:

Diagnosis is based on the following criteria:

the appearance of clinical manifestations after the use of the drug;
hereditary predisposition
similarity of symptoms with other allergic diseases;
the presence in the past of similar reactions to a drug with a similar composition or structure;
disappearance of manifestations (or tangible improvement) after discontinuation of the drug.

Diagnosis in some cases (with the simultaneous use of a number of drugs) is difficult when it is not possible to accurately establish the relationship between the onset of symptoms and a specific drug.

In cases where the origin of the symptoms is not clear, or the patient does not know which drug the reaction was to, laboratory diagnostic methods are used (detection of specific IgE class antibodies to drugs).

The level of IgE can be determined by enzyme immunoassay and radioallergosorbent test.

It eliminates the risk of complications, but is less sensitive and requires special equipment.

However, the imperfection of laboratory tests does not allow with a negative result with 100% certainty to exclude the possibility of hypersensitivity to the drug. The reliability of the study does not exceed 85%.

Skin tests to confirm LA in the acute period are not used because of the high risk of severe allergy.

They are also contraindicated in the presence of anaphylactic shock in the past, children under 6 years of age, during pregnancy.

Prevention

The development of LA is difficult to predict.

It is necessary to abandon the unreasonable use of medicines, often chosen as self-medication.

The simultaneous use of several drugs contributes to the occurrence of sensitization and subsequent LA.

The medicine should not be used in such cases:

the drug has previously (ever) caused an allergic reaction;
a positive test (even if the drug has not been previously prescribed to the patient); it is placed no earlier than 48 hours. before use, because sensitization may vary, although the test itself may lead to sensitization.

In case of emergency, in the presence of these contraindications, a provocative test is carried out, which allows, if appropriate symptoms appear, to carry out accelerated desensitization (measures to reduce hypersensitivity to the drug).

Provocative tests have a high risk of developing a severe immune reaction, which is why they are carried out extremely rarely, only in cases where the patient needs to be treated with a drug that he previously had LA.

These tests are carried out only in a hospital.

To avoid an acute allergic reaction, it is recommended:

injections of drugs, if possible, into the limb, so that if manifestations of intolerance to the drug appear, reduce the rate of its absorption by applying a tourniquet;
after injection, the patient should be observed for at least 30 minutes. (for outpatient treatment);
before starting a course of treatment (especially with antibiotics), it is advisable to conduct skin tests, having medicines (anti-shock kit) to provide emergency care in the development of an acute reaction and sufficiently trained personnel: first they put a drop test, then (if it is negative) - a scarification test; in some cases, an intradermal test is placed after it.

Lifelong treatment with this drug is contraindicated in patients with LA.

The likelihood of a reaction in any person is very high.

This is facilitated not only by the widespread use of household chemicals, but also by the widespread use of self-treatment.

At the same time, patients are guided by information from the Internet and use the opportunity to purchase medicines without prescriptions.

What are the symptoms of a cat allergy? More details in the article.

In many civilized countries, over-the-counter drug sales have been abandoned.

LA can have lifelong consequences and even be fatal. It is dangerous to be treated without consulting a doctor!

Drug allergies - symptoms, causes and treatment of drug allergies

Drug allergy is a secondary enhanced specific reaction of the body's immune system to the intake of drugs, which is accompanied by local or general clinical manifestations. Allergy to drugs is formed exclusively on the repeated administration of drugs. Drug allergy can manifest itself as a complication that occurs during the treatment of a disease, or as an occupational disease that develops as a result of prolonged contact with medicines.

According to statistics, drug allergies most often occur in women, mainly in people aged 31-40, and half of the cases of allergic reactions are associated with taking antibiotics. When taken orally, the risk of developing drug allergies is lower than with intramuscular injection and reaches the highest values when drugs are administered intravenously.

Treatment of drug allergies

Treatment of drug allergies begins with the abolition of the use of the drug, which caused an allergic reaction. In mild cases of drug allergy, a simple withdrawal of the drug is sufficient, after which the pathological manifestations quickly disappear. Often, patients have food allergies, as a result of which they need a hypoallergenic diet, with restriction of carbohydrate intake, as well as the exclusion from the diet of foods that cause intense taste sensations:

Drug allergy, manifested in the form of angioedema and urticaria, and is stopped by the use of antihistamines. If allergy symptoms persist, parenteral administration of glucocorticosteroids is used. Usually, toxic lesions of the mucous membranes and skin in drug allergies are complicated by infections, as a result, patients are prescribed broad-spectrum antibiotics, the choice of which is a very difficult problem. If the skin lesions are extensive, the patient is treated as a burn patient. Thus, the treatment of drug allergies is a very difficult task.

Symptoms of a drug allergy

Clinical manifestations of an allergic reaction to drugs are divided into three groups. Firstly, these are the symptoms that appear immediately or within an hour after the administration of the drug:

acute urticaria,
acute hemolytic anemia,
anaphylactic shock,
bronchospasm,
angioedema.

The second group of symptoms are allergic reactions of subacute type, which are formed 24 hours after taking the medicine:

And finally, the last group includes manifestations that develop over several days or weeks:

serum sickness,
damage to internal organs,
purpura and vasculitis,
lymphadenopathy,
polyarthritis,
arthralgia.

A skin rash is the most common symptom of a drug allergy. As a rule, it occurs a week after the start of the drug, is accompanied by itching and disappears a few days after the drug is discontinued. In 20% of cases, allergic kidney damage occurs, which is formed when taking phenothiazines, sulfonamides, antibiotics, occurs after two weeks and is detected as an abnormal sediment in the urine.

Liver damage occurs in 10% of patients with drug allergies. Cardiovascular lesions appear in more than 30% of cases. Lesions of the digestive organs occur in 20% of patients and manifest as:

With joint damage, allergic arthritis is usually observed, which occurs when taking sulfonamides, penicillin antibiotics and pyrazolone derivatives.

Allergy or side effects?

The latter is often confused with the concepts: “side effects on drugs” and “individual drug intolerance”. Side effects? these are undesirable phenomena that occur when taking drugs at a therapeutic dose indicated in the instructions for use. Individual intolerance? these are the same unwanted effects, just not listed as side effects and are less common.

Classification of drug allergies

Complications arising from the action of drugs can be divided into two groups:

Complications of immediate manifestation.
Complications of delayed manifestation:
- associated with changes in sensitivity;
- not associated with a change in sensitivity.

At the first contact with the allergen, there may be no visible or invisible manifestations. Since drugs are rarely taken once, the body's reaction increases as the stimulus accumulates. If we talk about the danger to life, then the complications of immediate manifestation come forward. Allergy after medication causes:

anaphylactic shock;
skin allergy from drugs Quincke's edema;
urticaria;
acute pancreatitis.

The reaction can occur in a very short time period, from a few seconds to 1-2 hours. It develops quickly, sometimes with lightning speed. Requires emergency medical care. The second group is more often expressed by various dermatological manifestations:

Shows up in a day or more. It is important to timely distinguish skin manifestations of allergies from other rashes, including those caused by childhood infections. This is especially true if a child is allergic to a medicine.

Risk Factors for Drug Allergy

Risk factors for drug allergy are drug exposure (drug sensitization is common in healthcare workers and pharmacists), long-term and frequent drug use (continuous use is less dangerous than intermittent use), and polypharmacy. In addition, the risk of drug allergy is increased by hereditary burden, fungal skin diseases, allergic diseases (pollinosis, bronchial asthma, etc.), the presence of food allergies.

Vaccines, sera, foreign immunoglobulins, dextrans, as substances of a protein nature, are full-fledged allergens (cause the formation of antibodies in the body and react with them), while most of the drugs are haptens, that is, substances that acquire antigenic properties only after connection with proteins of blood serum or tissues. As a result, antibodies appear, which form the basis of drug allergy, and when the antigen is re-introduced, an antigen-antibody complex is formed that triggers a cascade of reactions.

Any drugs can cause allergic reactions, including antiallergic drugs and even glucocorticoids. The ability of low molecular weight substances to cause allergic reactions depends on their chemical structure and the route of administration of the drug.

When ingested, the likelihood of developing allergic reactions is lower, the risk increases with intramuscular administration and is maximum with intravenous administration of drugs. The greatest sensitizing effect occurs with intradermal administration of drugs. The use of depot drugs (insulin, bicillin) often leads to sensitization. The “atopic predisposition” of patients may be hereditary.

In addition to true allergic reactions, pseudo-allergic reactions can also occur. The latter are sometimes called false-allergic, non-immuno-allergic. A pseudo-allergic reaction that is clinically similar to anaphylactic shock and requires the same vigorous measures is called anaphylactoid shock.

While not differing in clinical presentation, these types of drug reactions differ in their mechanism of development. With pseudo-allergic reactions, sensitization to the drug does not occur, therefore, the antigen-antibody reaction will not develop, but there is a nonspecific liberation of mediators such as histamine and histamine-like substances.

With a pseudo-allergic reaction, it is possible:

occurrence after the first dose of drugs;
the appearance of clinical symptoms in response to taking medications of various chemical structures, and sometimes to a placebo;
slow administration of the drug can prevent an anaphylactoid reaction, since the concentration of the drug in the blood remains below the critical threshold, and the release of histamine is slower;
negative results of immunological tests with the appropriate medication.

Histamine liberators include:

alkaloids (atropine, papaverine);
dextran, polyglucin and some other blood substitutes;
desferam (an iron-binding drug; used for hemochromatosis, hemosiderosis, overdose of iron preparations);
iodine-containing radiopaque agents for intravascular administration (reactions through complement activation are also possible);
no-shpa;
opiates (opium, codeine, morphine, fentanyl, etc.);
polymyxin B (ceporin, neomycin, gentamicin, amikacin);
protamine sulfate (drug for neutralizing heparin).

An indirect indication of a pseudo-allergic reaction is the absence of a burdened allergic history. A favorable background for the development of a pseudo-allergic reaction is hypothalamic pathology, diabetes mellitus, gastrointestinal diseases, liver disease, chronic infections (chronic sinusitis, chronic bronchitis, etc.) and vegetative dystonia. Polypharmacy and the introduction of drugs in doses that do not correspond to the age and body weight of the patient also provoke the development of pseudo-allergic reactions.

Causes of drug allergies

Drug allergy is an individual intolerance to the active substance of the drug or one of the auxiliary ingredients that make up the drug. At the heart of this pathology is an allergic reaction that occurs as a result of sensitization of the body to the active substance of the drug. This means that after the first contact with this compound, antibodies are formed against it. Therefore, a pronounced allergy can occur even with a minimal introduction of the drug into the body, tens and hundreds of times less than the usual therapeutic dose.

A drug allergy occurs after a second or third exposure to a substance, but never immediately after the first. This is due to the fact that the body needs time to produce antibodies against this agent (at least 5-7 days). The following patients are at risk of developing drug allergies:

using self-medication, often and for a long time taking medications;
people suffering from allergic diseases (bronchial asthma, atopic dermatitis, food allergies, pollinosis and others);
patients with acute and chronic diseases;
people with weakened immune systems;
young children;
people who have professional contact with drugs (pharmacists, doctors, employees of pharmaceutical plants and others).

An allergy can occur to any substance. However, most often it appears to the following drugs:

sera or immunoglobulins;
antibacterial drugs of the penicillin series and the group of sulfonamides;
non-steroidal anti-inflammatory drugs (aspirin, analgin and others);
painkillers (novocaine and others);
drugs, iodine content;
B vitamins;
antihypertensive drugs.

Cross-reactions to drugs containing similar substances may occur. So, in the presence of an allergy to novocaine, a reaction to sulfanilamide drugs may occur. A reaction to non-steroidal anti-inflammatory drugs may be combined with an allergy to food coloring.

Consequences of drug allergies

By the nature of the manifestations and possible consequences, even mild cases of drug allergic reactions potentially pose a threat to the life of the patient. This is due to the possibility of rapid generalization of the process in conditions of relative insufficiency of the therapy, its delay in relation to the progressive allergic reaction. The tendency to progression, aggravation of the process, the occurrence of complications is a characteristic feature of allergies in general, but especially medicinal ones.

First aid for drug allergies

First aid in the development of anaphylactic shock should be provided promptly and promptly. You must follow the algorithm below:

Stop further administration of the drug if the patient's condition worsens
Apply ice to the injection site, which will reduce the absorption of the drug into the bloodstream
Prick this place with adrenaline, which also causes vasospasm and reduces the absorption of an additional amount of the drug into the systemic circulation. For the same result, a tourniquet is applied above the injection site (periodically loosen it for 2 minutes every 15 minutes)
Take measures to prevent aspiration and asphyxia - the patient is placed on a hard surface, and the head is turned to the side, chewing gum and removable dentures are removed from the mouth
Establish venous access by placing a peripheral catheter
Administering a sufficient amount of fluids intravenously, while for every 2 liters you need to inject 20 mg of furosemide (this is forced diuresis)
With an intractable pressure drop, mezaton is used
In parallel, corticosteroids are administered, which exhibit not only antiallergic activity, but also increase the level of blood pressure.
If pressure allows, that is, systolic above 90 mm Hg, then diphenhydramine or suprastin is administered (intravenously or intramuscularly).

Drug allergies in children

In children, an allergy often develops to antibiotics, and more specifically to tetracyclines, penicillin, streptomycin and, a little less often, to cephalosporins. In addition, as in adults, it can also occur from novocaine, sulfonamides, bromides, B vitamins, as well as those drugs that contain iodine or mercury in their composition. Often, medicines during prolonged or improper storage are oxidized, broken down, as a result of which they become allergens.

Drug allergy in children is much more severe than adults - a common skin rash can be very diverse: vesicular, urticarial, papular, bullous, papular-vesicular or erythematosquamous. The first signs of a reaction in a child are an increase in body temperature, convulsions, and a drop in blood pressure. There may also be disturbances in the functioning of the kidneys, vascular lesions and various hemolytic complications.

The likelihood of developing an allergic reaction in children at an early age to a certain extent depends on the method of administration of the drug. The maximum danger is the parenteral method, which involves injections, injections and inhalations. This is especially possible in the presence of problems with the gastrointestinal tract, dysbacteriosis, or in combination with food allergies.

Also play an important role for the child's body and indicators of medicines such as biological activity, physical properties, chemical characteristics. They increase the chances of developing an allergic reaction of diseases that are infectious in nature, as well as a weakened work of the excretory system.

At the first symptoms, it is necessary to immediately stop the use of all drugs that the child has taken. Treatment can be carried out by a variety of methods, depending on the severity: the appointment of laxatives, gastric lavage, taking antiallergic drugs and enterosorbents. Acute symptoms require urgent hospitalization of the child, and, in addition to treatment, he needs bed rest and plenty of fluids.

It is always better to prevent than to cure. And this is most relevant in relation to children, since it is always more difficult for their body to cope with any kind of ailments than for an adult. To do this, it is necessary to be extremely careful and cautious in the choice of drugs for drug therapy, and the treatment of children with other allergic diseases or atopic diathesis requires special control.

If a violent reaction of the body in the form of unpleasant symptoms to a particular drug is detected, its repeated administration should not be allowed, and this information must be indicated on the front side of the child's medical record. Older children should always be informed about which drugs they may have an adverse reaction to.

Diagnosis of drug allergy

First of all, in order to identify and establish a diagnosis of drug allergies, the doctor conducts a thorough history taking. Often this diagnostic method is enough to accurately determine the disease. The main issue in the collection of anamnesis is an allergic anamnesis. And besides the patient himself, the doctor asks all his relatives about the presence of various types of allergies in the family.

Further, in case of not determining the exact symptoms or due to a small amount of information, the doctor conducts laboratory tests to diagnose. These include laboratory tests and provocative tests. Testing is carried out in relation to those drugs to which the body is supposed to react.

Laboratory methods for diagnosing drug allergies include:

radioallergosorbent method,
enzyme immunoassay,
Shelley's basophilic test and its variants,
chemiluminescence method,
fluorescent method,
test for the release of sulfidoleukotrienes and potassium ions.

In rare cases, the diagnosis of drug allergy is carried out using the methods of provocative tests. This method is applicable only when it is not possible to establish the allergen by taking an anamnesis or laboratory tests. Provocative tests can be carried out by an allergist in a special laboratory equipped with resuscitation devices. In today's allergology, the most common diagnostic method for drug allergy is the sublingual test.

How to treat drug allergies?

Allergy to drugs can be observed not only in people who are prone to it, but also in many seriously ill people. At the same time, women are more prone to the manifestation of drug allergies than males. It can be a consequence of an absolute overdose of medications in such cases when too much dosage is prescribed.

Take a cold shower and apply a cold compress to the inflamed skin.
Wear only clothes that won't irritate your skin.
Calm down and try to keep your activity level low. To reduce itching on the skin, use an ointment or cream designed for sunburn. You can also take an antihistamine.
Consult a specialist or call an ambulance, especially on the severity of symptoms. In the event that you have symptoms of anaphylaxis (severe allergic reaction, the state of the body begins to have hypersensitivity, urticaria), then try to remain calm until the doctor arrives. If you can swallow, take an antihistamine.
If you have difficulty breathing and are wheezing, use epinephrine or a bronchodilator. These medications will help widen the airways. Lie down on a flat surface (like the floor) and raise your legs. This will increase blood flow to the brain. Thus, you can get rid of weakness and dizziness.
Many allergic drug reactions go away on their own a few days after the drug that caused the reaction has been discontinued. Therefore, therapy, as a rule, is reduced to the treatment of itching and pain.
In some cases, the medication may be life-saving and therefore cannot be discontinued. In this situation, you have to put up with the manifestations and symptoms of allergies, for example, with hives or fever. For example, when treating bacterial endocarditis with penicillin, urticaria is treated with a glucocorticoid.
In the event of the most serious and life-threatening symptoms (anaphylactic reaction), difficulty in breathing or even loss of consciousness, epinephrine is administered.
Typically, your doctor will prescribe medications such as: steroids (prednisone), antihistamines, or histamine blockers (famotidine, tagamet, or ranitidine). For very severe reactions, the patient must be hospitalized for long-term therapy as well as observation.

Prevention of drug allergies

The patient's history must be taken responsibly. When identifying drug allergies in the history of the disease, it is necessary to note the drugs that cause an allergic reaction. These drugs should be replaced with another one that does not have common antigenic properties, thereby eliminating the possibility of cross-allergy. In addition, it is necessary to find out if the patient and his relatives suffer from an allergic disease. The presence of allergic rhinitis, bronchial asthma, urticaria, hay fever and other allergic diseases in a patient is a contraindication for the use of drugs with pronounced allergenic properties.

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Medicines are made from substances that are potentially toxic to the body. When taken in accordance with the instructions or a doctor's prescription, the drug does not cause intoxication and affects in a positive way. For example, it reduces pain, destroys infections and improves heart function. In addition to a positive reaction, medications have another effect that can negatively affect the functioning of human organs - and allergic reactions.

Symptoms of drug allergies can be divided into three groups. Type 1 symptoms include acute reactions that occur instantly or within an hour after taking the drug. Among them are anaphylactic shock, Quincke's edema, an attack of bronchial asthma, acute urticaria and anemia. Group 2 symptoms include reactions that appear within a day after taking the drug. In this case, the changes may not be noticeable to a person and can only be detected during blood tests. Protracted allergic reactions can be assigned to group 3. They develop several days after taking the drug and are the most complex. Type 3 includes serum sickness (rash, itching, fever, hypotension, lymphadenopathy, etc.), allergic blood diseases, inflammation in the joints and lymph nodes of various parts of the body.

Features of drug allergy

Drug allergy is distinguished by its paroxysmal onset. At the same time, the same drug after each dose can cause various allergic reactions, which differ not only in their type, but also in intensity.

Skin manifestations of allergies are one of the most common reactions. Spotted, nodular, blistering rashes may form on the skin, which may look like pink lichen, eczema, or exudative diathesis. The most common symptoms are Quincke's edema and urticaria, which are often the only manifestations of an allergic reaction to a particular drug. Most often, urticaria can appear due to the use of penicillin.

If a drug allergy occurs, the patient should contact the attending physician to prescribe an alternative drug. Before the consultation, you should stop taking the medication. For severe allergy symptoms, you can use antihistamines (for example, Claritin, Zyrtec, Flixonase). If the patient shows signs of anaphylactic shock, it is urgent to call an ambulance. You should also consult a doctor if a large-scale rash and bronchial asthma appear.

It is a secondary enhanced specific reaction of the body's immune system to taking medications, which is accompanied by local or general clinical manifestations.

The disease is an individual intolerance to the active substance of the drug or one of the auxiliary ingredients that make up the drug.

Allergy to drugs is formed exclusively on the repeated administration of drugs. The disease can manifest itself as a complication that occurs during the treatment of a disease, or as an occupational disease that develops as a result of prolonged contact with medicines.

A skin rash is the most common symptom of a drug allergy. As a rule, it occurs a week after the start of the drug, is accompanied by itching and disappears a few days after the drug is discontinued.

According to statistics, drug allergies most often occur in women, mainly in people aged 31-40, and half of the cases of allergic reactions are associated with taking antibiotics.

When taken orally, the risk of developing drug allergies is lower than with intramuscular injection and reaches the highest values when drugs are administered intravenously.

Symptoms of a drug allergy

Clinical manifestations of an allergic reaction to drugs are divided into three groups. Firstly, these are the symptoms that appear immediately or within an hour after the administration of the drug:

acute urticaria;
acute hemolytic anemia;
anaphylactic shock;
bronchospasm;
angioedema.

The second group of symptoms are allergic reactions of subacute type, which are formed 24 hours after taking the medicine:

maculo-papular exanthema;
agranulocytosis;
fever;
thrombocytopenia.

And finally, the last group includes manifestations that develop over several days or weeks:

serum sickness;
damage to internal organs;
purpura and vasculitis;
lymphadenopathy;
polyarthritis;
arthralgia.

In 20% of cases, allergic kidney damage occurs, which is formed when taking phenothiazines, sulfonamides, antibiotics, occurs after two weeks and is detected as an abnormal sediment in the urine.

Liver damage occurs in 10% of patients with drug allergies. Cardiovascular lesions appear in more than 30% of cases. Lesions of the digestive organs occur in 20% of patients and manifest as:

enteritis;
stomatitis;
gastritis;
gingivitis;
colitis;
glossitis.

With joint damage, allergic arthritis is usually observed, which occurs when taking sulfonamides, penicillin antibiotics and pyrazolone derivatives.

Descriptions of drug allergy symptoms:

Treatment of drug allergies

Often, patients have food allergies, as a result of which they need a hypoallergenic diet, with restriction of carbohydrate intake, as well as the exclusion from the diet of foods that cause intense taste sensations:

bitter;
salty;
sweet;
sour;
spices;
smoked meats, etc.

Drug allergy, manifested in the form of angioedema and urticaria, and is stopped by the use of antihistamines. If allergy symptoms persist, parenteral administration of glucocorticosteroids is used.

Usually, toxic lesions of the mucous membranes and skin in drug allergies are complicated by infections, as a result, patients are prescribed broad-spectrum antibiotics, the choice of which is a very difficult problem.

If the skin lesions are extensive, the patient is treated as a burn patient. Thus, the treatment of drug allergies is a very difficult task.

Which doctors to contact for drug allergies:

How to treat drug allergies?

Take a cold shower and apply a cold compress to the inflamed skin.

Wear only clothes that won't irritate your skin.

Calm down and try to keep your activity level low. To reduce itching on the skin, use an ointment or cream designed for sunburn. You can also take an antihistamine.

Consult a specialist or call an ambulance, especially on the severity of symptoms. In the event that you have symptoms of anaphylaxis (severe allergic reaction, the state of the body begins to have hypersensitivity, urticaria), then try to remain calm until the doctor arrives. If you can swallow, take an antihistamine.

If you have difficulty breathing and are wheezing, use epinephrine or a bronchodilator. These medications will help widen the airways. Lie down on a flat surface (like the floor) and raise your legs. This will increase blood flow to the brain. Thus, you can get rid of weakness and dizziness.

Many allergic drug reactions go away on their own a few days after the drug that caused the reaction has been discontinued. Therefore, therapy, as a rule, is reduced to the treatment of itching and pain.

In some cases, the medication may be life-saving and therefore cannot be discontinued. In this situation, you have to put up with the manifestations and symptoms of allergies, for example, with hives or fever. For example, when treating bacterial endocarditis with penicillin, urticaria is treated with a glucocorticoid.

In the event of the most serious and life-threatening symptoms (anaphylactic reaction), difficulty in breathing or even loss of consciousness, epinephrine is administered.

Typically, your doctor will prescribe medications such as: steroids (prednisone), antihistamines, or histamine blockers (famotidine, tagamet, or ranitidine). For very severe reactions, the patient must be hospitalized for long-term therapy as well as observation.

Allergy or side effects?

The latter is often confused with the concepts: “side effects on drugs” and “individual drug intolerance”. Side effects are undesirable effects that occur when taking drugs at a therapeutic dose, indicated in the instructions for use. Individual intolerance - these are the same undesirable effects, only not listed as side effects and are less common.

Classification of drug allergies

Complications arising from the action of drugs can be divided into two groups:

Complications of immediate manifestation.
Complications of delayed manifestation:
- associated with changes in sensitivity;
- not associated with a change in sensitivity.

Allergy after medication causes:

anaphylactic shock;
skin allergy from drugs, Quincke's edema;
urticaria;
acute pancreatitis.

erythroderma;
exudative erythema;
measles rash.

Risk Factors for Drug Allergy

In addition, the risk of drug allergies increases:

hereditary burden;
fungal diseases of the skin;
allergic diseases;
having a food allergy.

As a result, antibodies appear, which form the basis of drug allergy, and when the antigen is re-introduced, an antigen-antibody complex is formed that triggers a cascade of reactions.

When ingested, the likelihood of developing allergic reactions is lower, the risk increases with intramuscular administration and is maximum with intravenous administration of drugs. The greatest sensitizing effect occurs with intradermal administration of drugs. The use of depot drugs (insulin, bicillin) often leads to sensitization. The "atopic predisposition" of patients may be hereditary.

Causes of drug allergies

At the heart of this pathology is an allergic reaction that occurs as a result of sensitization of the body to the active substance of the drug. This means that after the first contact with this compound, antibodies are formed against it. Therefore, a pronounced allergy can occur even with a minimal introduction of the drug into the body, tens and hundreds of times less than the usual therapeutic dose.

The following patients are at risk of developing drug allergies:

using self-medication;
people suffering from allergic diseases;
patients with acute and chronic diseases;
people with weakened immune systems;
young children;
people who have professional contact with drugs.

An allergy can occur to any substance. However, most often it appears to the following drugs:

sera or immunoglobulins;
antibacterial drugs of the penicillin series and the group of sulfonamides;
non-steroidal anti-inflammatory drugs;
painkillers;
drugs, iodine content;
B vitamins;
antihypertensive drugs.

Consequences of drug allergies

The tendency to progression, aggravation of the process, the occurrence of complications is a characteristic feature of allergies in general, but especially medicinal ones.

First aid for drug allergies

First aid in the development of anaphylactic shock should be provided promptly and promptly. You must follow the algorithm below:

Stop further administration of the drug if the patient's condition worsens.

Apply ice to the injection site, which will reduce the absorption of the drug into the bloodstream.

Prick this place with adrenaline, which also causes vasospasm and reduces the absorption of an additional amount of the drug into the systemic circulation. For the same result, a tourniquet is applied above the injection site (periodically loosen it for 2 minutes every 15 minutes).

Take measures to prevent aspiration and asphyxia - the patient is placed on a hard surface, and the head is turned on its side, chewing gum and removable dentures are removed from the mouth.

Establish venous access by placing a peripheral catheter.

The introduction of a sufficient amount of fluids intravenously, while for every 2 liters it is necessary to inject 20 mg of furosemide (this is forced diuresis).

With an intractable pressure drop, mezaton is used.

In parallel, corticosteroids are administered, which exhibit not only antiallergic activity, but also increase the level of blood pressure.

If pressure allows, that is, systolic above 90 mm Hg, then diphenhydramine or suprastin is administered (intravenously or intramuscularly).

Drug allergies in children

Drug allergies in children are much more severe than adults - a common skin rash can be very diverse:

vesicular;
urticarial;
papular;
bullous;
papular-vesicular;
erythema-squamous.

The first signs of a reaction in a child are an increase in body temperature, convulsions, and a drop in blood pressure. There may also be disturbances in the functioning of the kidneys, vascular lesions and various hemolytic complications.

At the first symptoms, it is necessary to immediately stop the use of all drugs that the child has taken.

Treatment can be carried out by a variety of methods, depending on the severity:

prescription of laxatives;
gastric lavage;
taking antiallergic drugs;
use of enterosorbents.

Acute symptoms require urgent hospitalization of the child, and, in addition to treatment, he needs bed rest and plenty of fluids.

Diagnosis of drug allergy

Laboratory methods for diagnosing drug allergies include:

radioallergosorbent method;
enzyme immunoassay;
Shelley's basophilic test and its variants;
chemiluminescence method;
fluorescent method;
test for the release of sulfidoleukotrienes and potassium ions.

Prevention of drug allergies

In addition, it is necessary to find out if the patient and his relatives suffer from an allergic disease.

The presence of allergic rhinitis, bronchial asthma, urticaria, hay fever and other allergic diseases in a patient is a contraindication for the use of drugs with pronounced allergenic properties.

Pseudo-allergic reaction

While not differing in clinical presentation, these types of drug reactions differ in their mechanism of development. With pseudo-allergic reactions, there is no sensitization to the drug, therefore, the antigen-antibody reaction will not develop, but there is a nonspecific liberation of mediators such as histamine and histamine-like substances.

With a pseudo-allergic reaction, it is possible:

Histamine liberators include:

alkaloids (atropine, papaverine);
dextran, polyglucin and some other blood substitutes;
Desferam (an iron-binding drug);
iodinated radiopaque agents for intravascular administration;
no-shpa;
opiates;
polymyxin B;
protamine sulfate.

An indirect indication of a pseudo-allergic reaction is the absence of a burdened allergic history. The following diseases serve as a favorable background for the development of a pseudo-allergic reaction:

hypothalamic pathology;
diabetes;
gastrointestinal diseases;
liver disease;
chronic infections;
vegetative dystonia.

Polypharmacy and the introduction of drugs in doses that do not correspond to the age and body weight of the patient also provoke the development of pseudo-allergic reactions.

Questions and answers on the topic "Medicinal allergy"

Question:My mother and I have drug allergies (analgin, paracetamol, aspirin, almost all antipyretic drugs). Samples for paracetamol showed neg. reaction. How to cure it?

Answer: There is no cure for drug allergies. You just need to rule them out.

Question:What tests and where can be done to determine allergens for all groups of drugs? I have been allergic to drugs for more than ten years and cannot determine which ones. For various diseases, several drugs are prescribed and it is not possible to determine which allergies, since they are taken on the same day. Allergy - urticaria all over the body, but without itching, manifests itself after taking medications after a few hours, at first, with high fever, and only the next day there is a rash on the body. I can not determine the temperature from illness or from allergies. Accurately allergic to finalgon, sinupret (itching). Please help, every new medicine is a test of my body.

Answer: Such analyzes do not exist. The main thing in determining drug allergies is an allergic history, that is, recommendations are based on your experience with medications. Some tests can be done, but these are provocative tests, and they are done only when absolutely necessary. There are practically no reliable laboratory methods for determining drug allergies. About drugs to which you are definitely allergic: Finalgon is a drug with an irritating effect, often gives allergic reactions, Siluprent is a herbal drug, any herb that is part of it can cause allergies. Try to make a list of the medicines you have taken and in what combination. From this list, the allergist can determine the cause of the allergy and decide if you need any tests. In any case, if there is no emergency (very serious illness), you should start taking medicines one at a time and monitor your reaction.

Sometimes allergies come on unexpectedly and threateningly. What to do in such cases? How does an allergy to drugs manifest itself, how not to get confused if your life or the lives of loved ones are in danger? In order to answer these questions, you need to study your enemy. Allergy is a specific immune expressed in the production of antibodies and immune T-lymphocytes.

There are many types of specific reactions to various stimuli. The most insidious and dangerous is an allergy to drugs.

The danger lies in the fact that the disease may not appear immediately, but as the allergen accumulates in the body. Another difficulty rests on the symptoms of an allergy to drugs. They can be very different, and sometimes they are not associated with the use of a particular drug. In order to understand what steps should be taken for the timely diagnosis and treatment of drug allergies, the complications of drug allergies should be classified.

Classification

Complications arising from the action of drugs can be divided into two groups:

1. Complications of immediate manifestation.

2. Complications of delayed manifestation: a) associated with changes in sensitivity;

b) not associated with a change in sensitivity.

The reaction can occur in a very short time period, from a few seconds to 1-2 hours. It develops quickly, sometimes with lightning speed. Requires emergency medical care.

The second group is more often expressed by various dermatological manifestations:

erythroderma;
exudative erythema;
measles rash.

Stages of an allergy

Direct contact with the allergen. The emergence of the need to develop appropriate antibodies.
The release of specific substances by the body - allergic mediators: histamine, serotonin, bradykinin, acetylcholine, "shock poisons". The histamine properties of the blood are reduced.
There is a violation of blood formation, spasm of smooth muscles, cell cytolysis.
Direct manifestation of allergy according to one of the types described above (immediate and delayed manifestation).

The body accumulates an "enemy" element and shows symptoms of drug allergy. The risk is increased if:

There is a genetic predisposition (the presence of a drug allergy in one of the generations);

Long-term use of one drug (especially penicillin or cephalosporin antibiotics, aspirin-containing drugs) or several drugs;

The use of medicines without medical supervision.

Now the question arises, if there is an allergy to drugs, what should I do?

First aid for allergies with a complication of immediate manifestation

It is necessary to correctly assess the situation and act immediately. are essentially the same reaction. Multiple, itchy, porcelain-white or pale pink blisters begin to appear on the skin (urticaria). Then an extensive edema of the skin and mucous membranes develops (Quincke's edema).

As a result of edema, breathing becomes difficult and asphyxia occurs. In order to prevent death, you must:

Call for emergency medical attention immediately;

Rinse the stomach if the medicine has arrived recently;

If the medicine cabinet contains one of such drugs as Prednisolone, Dimedrol, Pipolfen, Suprastin, Diazolin, take it immediately;

Before the arrival of the ambulance, do not leave the victim for a minute;

To reduce skin itching, lubricate the surface of the blisters with a 0.5-1% solution of menthol or salicylic acid.

The most dangerous reaction of the body to a drug allergy is anaphylactic shock. The symptoms of drug allergy in this form are frightening. There is a sharp decrease in pressure, the patient turns pale, there is a loss of consciousness, convulsions. It's important not to panic. First aid:

Call "ambulance";

Turn your head to one side, unhook your teeth and pull out your tongue;

Lay the patient in such a way that the lower limbs are slightly higher than the head;

Of the medicines, the drug "Adrenaline" is used.

Quincke's edema and anaphylactic shock require immediate hospitalization.

First aid for allergies with complications of delayed manifestation

This is a less dangerous drug allergy. Treatment can be carried out at home, but under the supervision of a doctor.

How does a drug allergy manifest itself on the skin:

Limited rashes (on certain parts of the body);

Widespread rashes (rash uniform throughout the body);

The rash may be itchy, in the form of nodules, vesicles, patchy;

The manifestation of allergic erythema (lesion of the skin and oral mucosa with spots that have sharp boundaries). The spots cover more the internal (extensor) surfaces of the body.

Necessary:

Stop taking the drug that causes the allergy. If there were several drugs, antibiotics and drugs containing aspirin are primarily excluded;

Daily cleansing enemas;

The use of enterosorbents;

Intra-drop administration of cleansing preparations (hemodez).

Intramuscular and intravenous use of vitamins is advisable only if there is a 100% guarantee that there is no allergy to them.

If an allergy to the skin from drugs causes itching, baths from herbal decoctions, soda compresses are used to eliminate it.

Reasons for the development of drug allergies

The modern world cannot be called ecologically safe for mankind. Harmful substances of chemical, biological, toxic origin are emitted into the atmosphere every second. All this negatively affects the state of the immune system. Immunity failure entails terrible consequences: autoimmune diseases, allergy symptoms to drugs and other irritants.

1. When eating poultry and animals grown on modern feed, vaccinated with medical preparations, people do not even suspect that they come into contact with many medicines every day.

2. Frequent unreasonable use of drugs.

3. Inattentive study of the instructions for use of the drug.

4. Self-treatment.

6. The presence of stabilizers, flavors and other additives in medicines.

Also, we must not forget about the possibility of responding to mixing drugs.

Prevention

If there is an allergy to drugs, what to do so that it does not happen again? It is erroneously believed that the only way to prevent drug allergies is to refuse the drug that causes it. Strengthening the immune system has been and remains an important tool in the fight against allergies. The stronger the immune system, the less likely the occurrence of this dangerous disease.

Preventive measures include:

hardening.

Physical education and sports.

Proper nutrition.

No bad habits.

If there were allergic manifestations to any drugs, this should be indicated in the medical record.

The use of antihistamines before vaccinations.

Knowing that you have a drug allergy or any other form of allergy, it is better to always have it with you. If you are prone to shock, Quincke's edema, always keep an ampoule of adrenaline and a syringe in your pocket. It can save a life.

Before using anesthetics at the dentist's appointment, ask for a test.

If you follow these tips, the symptoms of an allergy to drugs will not recur.

Results

If a car enthusiast starts filling his iron horse with low-quality gasoline, the car will not last long. For some reason, many of us do not think about what they put on their plate. A balanced diet, clean water is the key to strong immunity and the ability to say goodbye not only to food, but also drug allergies. Any disease leads a person who learns about it to a state of shock. Over time, it becomes clear that most of our diseases require not so much treatment as lifestyle changes. Drug allergies are no exception. In the modern world, and especially in the post-Soviet space, there is a lack of attention to one's health at the proper level. This leads to undesirable and sometimes fatal consequences. It is cheaper and easier to prevent a disease than to spend money and effort on its treatment later. Now that it is known how an allergy to drugs manifests itself, knowing the enemy in person, it is easier to deal with him. Be healthy.

The general availability of drugs has led to frequent cases of drug allergies. Such an allergy is characterized by a multiplicity of symptoms, it may appear suddenly, it may not manifest itself in any way for weeks.

Drug allergy can occur in a man, woman, teenager, infant. Each drug can become an allergen, the effect of which is reflected on the skin, visual system, and internal organs.

What is a drug allergy?

- an individual reaction of the body to a drug taken orally, administered intravenously or intramuscularly.

Allergic reactions to the administered drug can occur in patients of both sexes and any age category. The disease is more common in middle-aged and older women.

Developing during the acute course of the disease, drug allergy exacerbates its course, leading to patient disability and death.

In clinical practice, groups of patients are distinguished in whom the development of an allergy to drugs is most likely to be predicted:

Employees of pharmaceutical enterprises and pharmacies, doctors, nurses - all those who are in permanent contact with drugs;
Persons with a history of other types of allergies;
Patients with a genetically determined predisposition to allergies;
Patients suffering from any kind of fungal diseases;
patients with liver diseases, disorders in the functioning of the enzyme and metabolic systems.

Drug allergy has a number of features that make it possible to identify it from pseudo-allergic reactions:

Signs of drug allergy are different from side effects of the drug;
The first contact with the drug passes without reaction;
In the occurrence of a true allergic reaction, the nervous, lymphatic and immune systems are always involved;
The body needs time for sensitization - a slow or fleeting increase in the body's sensitivity to a stimulus. A full reaction develops upon repeated contact with the drug. The formation of sensitization in terms of time takes from several days to several years;
For a drug allergic reaction, a microdose of the drug is sufficient.

The level of sensitivity is affected by the drug itself, the way it is introduced into the body, the duration of administration.

The risk of developing an allergy to drugs increases with the simultaneous use of several medications, in the presence of chronic infectious processes, and with dysfunction of the endocrine system.

Why does drug allergy occur?

At present, it is not exactly established for drugs.

Experts talk about a complex of causal factors that provoke a painful reaction of the body:

The factor of heredity- It has been reliably established that the predisposition to allergies is inherited. An allergic person always has blood relatives suffering from some kind of allergy;
Use of hormones and antibiotics in agriculture- when using such products, the sensitivity of the human body to the drugs administered to the animal increases;
General availability of medicines- leads to their uncontrolled use, violation of the shelf life, overdose;
Associated pathologies- inadequate immune response of the body is caused by chronic diseases, helminthiases, disturbances in the functioning of the hormonal system.

Stages of an allergy

Allergy to drugs in its development goes through the following stages:

Immunological- the initial stage of contact of the allergen with the body. The stage at which the body's sensitivity to the administered drug only increases; allergic reactions do not appear;
pathochemical- the stage at which biologically active substances begin to be released, "shock poisons". At the same time, the mechanism of their suppression is deactivated, the production of enzymes that suppress the action of allergy mediators decreases: histamine, bradykinin, acetylcholine;
Pathophysiological- the stage at which spastic phenomena are observed in the respiratory and digestive systems, the processes of hematopoiesis and blood clotting are disturbed, its serum composition changes. At the same stage, the endings of nerve fibers are irritated, there is a sensation of itching and pain that accompanies all types of allergic reactions.

Symptoms of drug allergy

In fact, it has been established that the severity of symptoms and the clinical picture of drug allergy are associated with the form of drug use:

There are three groups of reactions characteristic of drug allergies:

Acute or immediate type- are characterized by a lightning current. The development time is from several minutes to an hour after contact with the allergen.
How specific manifestations are considered:
- - the appearance of pale pink blisters slightly raised above the surface of the skin, with the progression of the process, the blisters merge with each other into one spot;
- angioedema- total swelling of the face, oral cavity, internal organs, brain;
- bronchospasm- violation of the patency of the bronchi;
- anaphylactic shock;
Subacute reactions- from the time of contact with the allergen until the first signs appear, a day passes.
The most prominent symptoms include:
- feverish conditions;
- maculopapular exanthema;
Delayed reactions— time limits of development are stretched. The first signs are fixed both a few days and a few weeks after the administration of the drug.
The characteristic manifestations are:
- polyarthritis;
- arthralgia;
- serum sickness;
- defeat or change in the functions of internal organs and systems;
- inflammation of blood vessels, veins, arteries;
- violation of the functions of hematopoiesis.

For any form and type of allergy to drugs, lesions of the dermis, respiratory, visual, and digestive systems are characteristic.

Common symptoms include:

What medications cause an allergic reaction?

An allergic reaction can be provoked by the most familiar and harmless medicine.

Drug allergies are more likely to be caused by antibiotics, antipyretics, insulin and anesthetics.

Allergy to antibiotics

The most striking symptoms are caused by inhalation use of drugs. An allergic process develops in 15% of patients.

There are more than 2000 antibiotics, different in chemical composition and spectrum of action.

Penicillins

If you are allergic to any type of penicillin, all drugs of this series are excluded.

The most allergenic have:

Penicillin;
Ampiox;
Ampicillin.

Allergic reactions manifest themselves as:

rashes;
gastrointestinal disorders;
hives.

With intravenous and intramuscular administration of Ampiox and Ampicillin, there is a possibility of developing anaphylactic shock.

Cephalosporins

For any manifestations of allergy to penicillin drugs, the use of cephalosporins is excluded due to their structural similarity and the risk of cross-reactions.

At the same time, the possibility of developing severe allergic processes is small. Allergic manifestations in adults and children are similar, they consist in the appearance of a variety of rashes, urticaria, tissue edema.

The greatest number of allergic reactions cause drugs of the first and second generations:

Kefzol;
Cephalexin;
Nacef;
Biodroxil.

Macrolides

Preparations for use when it is impossible to use penicillins and cephalosporins.

The greatest number of allergic reactions was recorded with the use of Oletetrin.

Tetracyclines

Characteristic signs of drug allergy occur when using:

Tetracycline;
Tetracycline ointment;
Tygacil;
Doxycycline.

The possibility of allergic cross-reactions between representatives of the series has been established. Allergic reactions occur rarely, proceed according to the reaginic type, manifest themselves in the form of a rash and urticaria.

As a specific manifestation of allergy, when using Demeclocycline, Doxycycline, Oxyetracycline, there have been cases of increased skin sensitivity to sunlight.

Aminoglycosides

Allergic reactions develop mainly to sulfites, which are part of the preparations of this series. With the greatest frequency, allergic processes develop with the use of Neomycin and Streptomycin.

With long-term use of drugs, it is noted:

hives;
feverish state;
dermatitis.

Allergy to anesthetics

Most patients are allergic not to the anesthetic itself, but to the preservatives, latex or stabilizers that are part of them.

The greatest number of occurrences of drug allergies is observed when using Novocaine and Lidocaine. Previously, it was considered possible to replace Novocain with Lidocaine, however, there have been cases of anaphylactic reactions to both drugs.

Allergy tests are performed to avoid the development of an allergy to anesthetics. The patient is injected with a small amount of medication with monitoring of the reaction.

Allergy to antipyretics

The first cases of an inadequate response of the body to aspirin were noted at the beginning of the last century.

In 1968, aspirin allergy was made into a separate respiratory disease.

Variants of clinical manifestations are diverse - from slight reddening of the skin to severe pathologies of the respiratory tract.

Clinical manifestations are aggravated in the presence of fungal diseases, liver pathologies, and metabolic disorders.

An allergic reaction can be caused by any antipyretic that contains paracetamol:

ibuprofen;
Paracetamol;
Panadol;
Nurofen.

Allergy to sulfonamides

All drugs of this series have a sufficient degree of allergenicity.

Of particular note are:

Biseptol;
Sulfadimethoxine;
Argosulfan.

Allergic reactions are manifested in the form of intestinal disorders, vomiting, nausea. On the part of the skin, the appearance of a generalized rash, urticaria and edema was noted.

The development of more serious symptoms occurs in exceptional cases, and consists in the development of erythema multiforme, fever, and blood disorders.

The target for sulfonamides is the liver, jaundice often develops, in medical practice there are cases when an allergy to such drugs led to liver dystrophy and death.

Allergy to iodine-containing drugs

Typical reactions include the appearance of an iodine rash or iododermatitis. In places of contact between the skin and the iodine-containing preparation, erythema and an erythematous rash are observed. When the substance gets inside, iodine urticaria develops.

The response of the body can cause all drugs, which include iodine:

Alcoholic infusion of iodine;
Lugol's solution;
Radioactive iodine, used in the treatment of the thyroid gland;
Antiseptics, such as Iodoform;
Iodine preparations for the treatment of arrhythmias - Amidoron;
Iodine preparations used in radiopaque diagnostics, for example, Urografin.

As a rule, iodine reactions are not dangerous, after discontinuation of the drug they quickly disappear. Only the use of radiopaque preparations leads to serious consequences.

It is possible to track the reaction to iodine at home. It is enough to apply an iodine grid and observe the patient's reaction. With the appearance of inflammation, rash, edema, the use of iodine-containing drugs is stopped.

allergy to insulin

The development of an allergic process is possible with the introduction of any type of insulin. The development of reactions is due to a significant amount of protein.

To a greater or lesser extent, allergies can occur when using these types of insulin:

Insulin Lantus- the reaction is insignificant in the form of rashes, redness, slight swelling;
Insulin NovoRapid- some patients develop bronchospasm, severe edema, skin hyperemia;
Insulin Levemir The symptoms are similar to those of a food allergy:
- rough elbows and knees;
- redness of the cheeks;
- itching of the skin.

To exclude the development of a drug disease, a small amount of insulin is initially administered to the patient, and only in the absence of allergy symptoms, the usual dosage is prescribed.

If the symptoms of drug allergy cannot be stopped, insulin injections are made with the simultaneous administration of hydrocortisone. In this case, both drugs are collected in one syringe.

Allergy to tuberculin

The development of an allergic process is caused by both immunological tests:

Pirquet's reaction - when the drug is applied to the skin scratched by the scarifier;
Mantoux reaction - when the sample is injected.

The reaction occurs both to tuberculin itself and to the phenol that is part of the vaccine.

Allergic processes are manifested in the form of:

Allergy to vaccines

Allergy to vaccines develops as a pathological response of the body to any component of the vaccine:

The most dangerous in allergology are:

DTP vaccination- manifested by severe dermatological symptoms;
Hepatitis B vaccination- not used in case of detection of a reaction to the nutritional yeast that is part of the vaccine;
Polio vaccine- the reaction occurs on both of its forms - inactivated and oral. The development of allergic processes is most often seen in patients with a reaction to kanamycin and neonacin;
Tetanus vaccine- allergic manifestations are serious, up to Quincke's edema.

Diagnostics

Diagnostics includes:

Laboratory methods of examination

The current methods of instrumental diagnostics include:

Provocative tests

In the diagnosis of drug allergy, provocative tests are rarely used, and only in cases where the relationship between the use of the drug and the development of the reaction cannot be established, and the drug must continue to be used for health reasons.

The following tests are carried out:

Sublingual test- either the medicine is used in tablet form, or its aqueous solution. A tablet or sugar with drops of the drug is placed under the tongue. After a few minutes, the patient shows the first signs of allergy;
Dosed provocation- in very small doses, the patient is injected subcutaneously or intramuscularly with a medication. Medical supervision after the administration of the drug is at least half an hour.

There are a number of conditional and unconditional contraindications to such tests:

Acute course of any type of allergy;
Postponed anaphylactic shock;
Diseases of the kidneys, liver, heart in the stage of decompensation;
Severe damage to the endocrine glands;
gestation period;
The child is under six years of age.

First aid for allergies with a complication of immediate manifestation

The value of timely assistance with Quincke's edema and anaphylactic shock cannot be overestimated.

The count goes to the minutes during which a person's life can be saved:

Treatment of drug allergies

In severe forms, the help of an allergist and treatment in a hospital is necessary. The first step in treating a drug allergy is to stop the drug that caused the allergy.

In the case when the abolition of the drug is impossible for health reasons, its administration or administration is carried out with the simultaneous use of antihistamines.

Therapeutic treatment is based on the use of sedative, absorbent, antihistamine drugs and is as follows:

Sorbent preparations- in the case of oral administration of a drug that caused an allergy, the patient is washed with a stomach, and sorbents are prescribed, such as Polysorb, Enterosgel or activated charcoal;
Oral antihistamines- such drugs as Tavegil, Suprastin are necessarily prescribed;
Topical preparations- to relieve local reactions, Fenistil gel is prescribed for mild symptoms, as well as Advantan, which is a hormonal drug for severe symptoms;
- in cases of persisting acute symptoms, Prednisolone is administered intramuscularly. And also in such cases, intravenous diffusion with sodium chloride is carried out.

Anaphylactic shock requires anti-shock therapy. Treatment is carried out in intensive care units. The patient will be prescribed antihistamines and hormonal agents, they will take measures that control the work of internal organs and systems.

Patients in need of hospital treatment:

with Quincke's edema in the neck;
with severe violations of the bronchi;
with a severe form of bullous dermatitis;
Steven-Johnson syndrome;
with dysfunctions of internal organs.

Such patients are intravenously injected with solutions that compensate for the pathological losses of the body, parenterally administered glucocotic steroids and antihistamines.

Most often, an allergy to drugs in children occurs on antibiotics, sulfonamides, and antipyretic drugs.

There are frequent cases of the development of positive reactions to iodine-containing drugs, bromides, novocaine, drugs of group B.

The danger is mainly intravenous and intramuscular administration of the drug. Oral administration has less severe consequences.

The situation is aggravated against the background of diseases of the gastrointestinal tract, dysbacteriosis, food allergies.

As symptoms of drug allergy in children, the following are considered:

Allergy to drugs in a child can manifest itself in the form of severe systemic processes or reactions of an immediate type, for example, Quincke's edema, anaphylactic shock, or Lyell and Steven-Johnson syndromes.

Against the background of the above manifestations, the child's sleep and appetite deteriorate, the temperature rises, and the digestive tract is disturbed.

At the first signs of a drug allergy, the child is washed with a stomach, given saline solutions. The doctor prescribes sorbents and antihistamines in the right dosage, as well as probiotics to restore the child's microflora.

More severe cases require immediate medical attention and hospital treatment.

Precautions for drug allergies

There are certain precautions to avoid the consequences:

Patients who are allergic to any drug are prohibited from using it for life;
Not only the irritant drug is canceled, but also its analogues, similar in composition and causing cross-reactions;
Complex preparations are not prescribed for use if their components cause allergies or cross-reactions. So, with an allergy to acetylsalicylic acid, Citramon becomes a provocateur of the reaction;
Patients with a diagnosed drug allergy should avoid the use of three or more medications;
If, according to indications, the use of a large number of drugs is necessary, then they are taken at intervals of 1.5-2 hours.

Prevention of drug allergies

Prevention of allergy to drugs is based on the following principles:

Conclusion

Both pharmacology and medicine do not stand still. Diseases that were considered fatal a few years ago are being cured. But each tablet is a foreign agent for the body, the reaction can be unpredictable.

Attentive attitude to your health, to medicines, compliance with the rules for taking medications will help to avoid the development of an allergy to medicines.