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Adverse Drug Reactions: Types and Treatment Options


image: Adverse Drug Reactions: Types and Treatment Options

Source: www.aafp.org
Topic: Drugs
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Sort Desciption: some drug hypersensitivity reactions are diffi- cult to classify ... Drug hypersensitivity results from interactions between a pharmacologic agent and the ...

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Adverse Drug Reactions: Types and Treatment Options maining 20 to 25 percent of adverse drug events are caused by unpredictable effects that may or may not be immune mediated. 1 Immune-mediated reactions account for 5 to 10 percent of all drug reactions and constitute true drug hypersensitivity, with IgE-mediated drug allergies falling into this category. 2,3 The Gell and Coombs classification system describes the predominant immune mechanisms that lead to clinical symptoms of drug hypersensitivity (Table 2). This classification system includes: Type I reactions (IgE-mediated); Type II reactions (cytotoxic); Type III reactions (immune complex); and Type IV reactions (delayed, cell-mediated). However, some drug hypersensitivity reactions are difficult to classify because of a lack of evidence supporting a predominant immunologic mechanism. These include certain cutaneous drug reactions (i.e., maculopapular rashes, erythroderma, exfoliative dermatitis, and fixed drug reactions) 4,5 and specific drug hypersensitivity syndromes (Table 3). 6,7 Unpredictable, nonimmune drug reactions can be classified as pseudoallergic, idiosyncratic, or intolerance. Pseudoallergic reactions are the result of direct mast cell activation and Adverse drug reactions are common. Identifying true drug allergy, however, can be challenging. Complicating factors of drug reactions include the myriad clinical symptoms and multiple mechanisms of drug-host interaction, many of which are poorly understood. In addition, the relative paucity of laboratory testing that is available for drug allergy makes the diagnosis dependent on clinical findings. Definitions and Classifications The terms drug allergy, drug hypersensitivity, and drug reaction are often used interchangeably. Drug reactions encompass all adverse events related to drug administration, regardless of etiology. Drug hypersensitivity is defined as an immune-mediated response to a drug agent in a sensitized patient. ...

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