Question

Choose one medication allergy commonly seen in practice. What cross-sensitivities could patients with this medication allergy experience? What potential complications and reactions could this patient have and what treatment is available?

Answer 1

Question : Choose one medication allergy commonly seen in practice.

Answer : Penicillin

Penicillin is the most common drug allergy. If you experience an allergic reaction after taking Penicillin, it is more likely to happen. Anticonvulsant, aspirin, ibuprofen and chemotherapy drug allergies are also common.amoxicillin, ampicillin, amoxicillin-clavulanate, dicloxacillin, nafcillin, piperacillin-tazobactam

Question : What cross-sensitivities could patients with this medication allergy experience?

Answer : There's usually itching, redness, and swelling at the site of the skin prick.

• Skin rash.
• Hives.
• Itching.
• Fever.
• Swelling.
• Shortness of breath.
• Wheezing.
• Runny nose.

(More recent literature reviews have concluded that the overall cross-reactivity rate for penicillin allergic patients is approximately 1% when using first-generation cephalosporins or cephalosporins with similar R1 side chains)

Question : What potential complications and reactions could this patient have?

Answer :

• Serum sickness, which may cause fever, joint pain, rash, swelling and nausea
• Drug-induced anemia, a reduction in red blood cells, which can cause fatigue, irregular heartbeats, shortness of breath, and other signs and symptoms
• Drug reaction with eosinophilia and systemic symptoms (DRESS), which results in rash, high white blood cell counts, general swelling, swollen lymph nodes and recurrence of dormant hepatitis infection
• Stevens-Johnson syndrome or toxic epidermal necrolysis, which involves severe blistering and peeling of the skin
• Inflammation in the kidneys (nephritis), which can cause fever, blood in the urine, general swelling, confusion, and other signs and symptoms

Question : what treatment is available?

Answer :

The following interventions may be used to treat the symptoms of an allergic reaction to Penicillin and to avoid complications :

• Withdrawal of the drug. If your doctor determines that you have a penicillin allergy — or likely allergy — discontinuing the drug is the first step in treatment.
• Antihistamines. Your doctor may prescribe an antihistamine or recommend an over-the-counter antihistamine such as diphenhydramine (Benadryl) that can block immune system chemicals activated during an allergic reaction.
• Corticosteroids. Either oral or injected corticosteroids may be used to treat inflammation associated with more-serious reactions.
• Treatment of anaphylaxis. Anaphylaxis requires an immediate epinephrine injection as well as hospital care to maintain blood pressure and support breathing.

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