Drug allergy overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2]

Drug Allergy

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Overview

Classification

Pathophysiology

Causes

Differentiating Drug allergy from other Diseases

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Overview

A drug allergy is a reaction to a drug that specifically occurs through immunologic activation in response to a drug. The term immunologic drug reaction is an alternative term for drug allergy. A drug allergy is an allergy to a drug, most commonly a medication.

Classification

Drug allergies are classified using two main sets of criteria. One is set forth by the World Allergy Association, and classifies the reaction as to whether it occurs within one hour of treatment, or after one hour. The other set of criteria are based on the type of immunologic reaction that occurred and the mediators involved.

Pathophysiology

An allergic reaction will not occur on the first exposure to a substance. The first exposure allows the body to create antibodies and memory lymphocyte cells for the antigen. However, drugs often contain many different substances, including dyes, which could cause allergic reactions. This can cause an allergic reaction on the first administration of a drug. For example, a person who developed an allergy to a red dye will be allergic to any new drug which contains that red dye. Medications can cause allergic reactions through various mechanisms. The drug can either act as a direct antigenic particle, or it can cause activation of immune cells by the direct interaction with immune cell receptors.

Causes

The types of drugs that can cause drug allergies vary. Drugs containing sulfa are common in causing drug allergy reactions. Other common drugs implicated in leading to an allergic reaction are antibiotics, insulin, and iodinated drugs.

Differentiating Drug Allergy from other Diseases

A drug allergy is different from an intolerance. A drug intolerance, which is often a milder, non-immune-mediated reaction, does not depend on prior exposure. Most people who believe they are allergic to aspirin are actually suffering from a drug intolerance.

References

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