Allergic Reactions

Drugs or their reactive metabolites can cause an allergic reaction in patients that may be due to either cell-mediated or antibody-mediated reactions. There are various clinical manifestations of hypersensitivity reactions:

  • anaphylaxis, which can be life-threatening when respiration is impaired— most deaths from this are due to penicillin
  • haematological reactions - agranulocytosis, haemolytic anaemia or thrombocytopenia - may develop and can sometimes be irreversible
  • some patients may have a glucose-6-phosphate dehydrogenase (G6PD) deficiency that can lead to a potentially fatal reaction to some drugs such as sulphonamides
  • skin rashes, ranging from very mild to life-threatening (such as Stevens-Johnson syndrome).

Allergy status must always be confirmed and recorded before the administration of any drug, and patients should be informed of any potential signs or symptoms to watch out for if they are at risk of an allergic reaction.

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