Journal
MEDICAL CLINICS OF NORTH AMERICA
Volume 104, Issue 1, Pages 109-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.mcna.2019.09.003
Keywords
Adverse drug reaction; Drug hypersensitivity reaction; Drug allergy; Drug rash; Skin testing; Graded challenge; Desensitization
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Drug hypersensitivity reactions (DHRs) may be classified based on timing (immediate vs delayed), mechanisms, and pattern of clinical manifestations. Management may include selection of alternative, non-cross reactive agents, drug allergy testing, graded challenge and/or desensitization. Immediate skin testing only identifies risk for immediate-type allergic DHR and has a negative predictive value for only a limited number of drugs (eg, penicillin). Desensitization induces a temporary state of tolerance that is maintained only so long as the drug is continued. This article discusses special considerations about antibiotics, angiotensin-converting enzyme inhibitors, anesthetic agents, aspirin and nonsteroidal antiinflammatory drugs, radiocontrast media, and chemotherapeutic agents.
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