Unfortunately, there has been a serious increase in the incidence of allergic reactions with the drugs that have been developed consecutively for the diagnosis and treatment of diseases.
In fact, most drugs are not allergic by themselves. However; When they enter the body, they combine with some proteins and gain allergic activity. In addition, dyes and preservatives used during the production of many drugs may also be responsible for allergic reactions.
Drug allergies are not common reactions according to scientific data. Despite this, there are so many patients diagnosed with drug allergy that; We can encounter many patients who think they have these allergic reactions. The problem here may be that almost all side-effect reactions of patients with drugs are attributed to drug allergies. However; True drug allergies have a number of characteristics. The one who will evaluate this is an absolute and absolute allergy and immunology specialist. For example; In a study conducted in the USA with a not small number of patients (36 653 patients), side effects related to drugs were found at a rate of 1.67%, while only 10% of them were found to be true drug allergies. Again, in only 8 of these patients, an allergic reaction was found to be life-threatening.
Are All Reactions With Medicines Allergic?
Our answer to this question is without hesitation: “no it is not !!!”. Medicines; Apart from allergies, they can cause reactions in the form of their own toxic effects, intolerance reactions in people, tolerance disorders and unexpected side effects called idiosyncrasy. Reactions other than allergies are generally dose dependent. One of the important clues in a case suggesting drug allergy; Having a family history of allergic disease. Such people are at risk for drug allergies. In addition, it should be known that; An allergic reaction does not occur after the first intake of a drug. In order to develop an allergic reaction to this drug, the person must have taken this drug or a similar molecule before. The situation is actually a bit confusing here. Because; There are so many equivalent drugs or drugs with similar molecules that the person may have taken the drug or similar that has a reaction before without realizing it. For this reason, it is necessary to scrutinize the patient’s disease history in full.
How Do Drug Allergies Give Symptoms?
Drug allergies, in addition to life-threatening and unfortunately fatal conditions called anaphylaxis, fever, hives, angioedema, allergic skin disease, destruction of blood cells, kidney inflammation, vascular inflammation, liver inflammation and obstruction of bile ducts, It can cause conditions similar to rheumatic diseases, light allergy.
Which Medicines Can Cause Allergy?
Most commonly, antibiotics cause drug allergies. Antibiotics are responsible for 45% of drug allergies. In fact, this is due to the unnecessary and extremely frequent use of antibiotics in one place in our society and around the world. Perhaps, as physicians, we provide an important opportunity for people to encounter such molecules unnecessarily and to recognize this molecule and begin to exhibit an allergic state to it. However; In my opinion, no doctor prescribes unnecessary medicine. Unfortunately; One of the most important problems in our society is that in case of any illness, people can take their medicines without consulting a doctor, without examination, without having their tests done, either with the advice of a friend or sometimes directly from the pharmacy themselves. It should not be forgotten that no disease may create the same clinical picture in all people. In other words, there may be many diseases that cause similar clinical pictures, and therefore physicians must undertake the diagnosis and treatment of these. Apart from this, aspirin and rheumatism drugs are among the important causes of drug allergy. They are also responsible for 17% of drug allergies. Apart from these, the drugs used to take color x-ray films are also responsible for allergies. Tooth extractions and narcotic drugs used in surgeries are also important causes of drug allergy.
Among all these drugs, penicillin and penicillin allergy are the most frequently mentioned. Although the incidence varies according to various studies, it varies between 0.7-10%. As mentioned before, in order for an allergic reaction to occur to a drug, the person must have encountered that drug before. However, sometimes people who are allergic to penicillin-producing molds and people who drink the milk of animals treated with penicillin can also experience an allergic reaction without taking penicillin before. The most common finding in penicillin allergy is hives; however, anaphylaxis reactions attract more attention due to their fatal consequences.
Anesthetic (used to numb the entrance area or the patient before surgery or interventions) has recently attracted attention. A serious allergic reaction may occur in every 5000-15000 surgeries. While some of them are due to anesthetic agents, some are due to latex, which is frequently encountered especially in operating room conditions and during surgery. Local anesthetics used especially in minor surgeries and dental interventions may also cause side effects; however, few of them are true drug allergies.
Many drugs other than these drugs can cause an allergic reaction. For example; Allopurinol used in gout, antibiotic class quinolones, drugs containing sulfa, epilepsy drugs, some hormones (for example, insulin)…
Apart from these reactions, some drugs may cause a condition called pseudo-allergic reaction. These include Aspirin and other rheumatism drugs, colored film materials, some blood pressure medications, morphine, vitamin K, and drugs that are used in some cases and provide iron excretion from the body (desferroxamine).
Although the most well-known side effects of aspirin and other rheumatism drugs are on the stomach, they often cause problems due to pseudo-allergic reactions such as hives, bronchial tightness, colds and inflammation of the eye mucosa.
How Do I Know If I Have a Drug Allergy, Should I Have a Test?
If you have had an allergic reaction (hives, eye and nose inflammation, shortness of breath, cough, chest tightness, allergic skin disease) to any drug before, the best way is not to use this drug again. In addition, you should tell the doctor you go to for any reason in detail about your situation. To investigate the presence of drug allergy, allergy skin test and blood allergy test for some drugs (for example, penicillin) can be done. But this should only be done for drugs that you currently need to use. It is neither practical nor logical to pre-test for drugs that will not be used.
Treatment
The most important treatment is avoidance of the drug responsible for drug allergy. In addition, such practices should be avoided as unnecessarily inappropriate use of drugs in inappropriate doses will also invite drug allergy. The first thing to do, including mild conditions such as hives and allergic skin disease, is to discontinue the drug used. Immediately after this, you should consult your allergy and immunology doctor without wasting time.
Advice for People with Drug Allergies
• Inform all of your family (family and work environment) about this situation,
• Carry a document stating that you have a drug allergy. Include in this document a list of all the medications you are allergic to.
• In case of needing drug treatment or operation for any reason, show this list to the doctor who will carry out your treatment, and also consult your allergy and immunology specialist,
• Many drugs contain the same active ingredient even though they have different names. Because; If you have a known and proven drug allergy, do not use drugs without consulting your allergy and immunology doctor.
Wishing you healthy days…
Prof. Dr. Cengiz KIRMAZ
