Allergies and drug intolerances are responsible for a mortality and morbidity representing a daily problem for patients that develop them as well as for prescribing physicians.
However, it is important to distinguish allergy from drug intolerance. In fact, only 1/5 of the patients consulting for a suspicion of drug allergy really present an allergy. The drug allergy is always associated with an immune mechanism where antibodies and/or activated T-lymphocytes are revealed, directed against the drugs. These immune mechanisms are multiple. In fact, drugs are able to induce all of the Gell and Coombs immune reactions.
Whether induced by drugs or their metabolites,
allergic reactions may occur in multiple forms, from the benign
skin rash, to the anaphylactic shock or skin detachment (toxic
epidermal necrosis).
All drugs are able to induce allergic reactions. The drugs
most often involved are:
Antibiotics
- ß-lactamines
- antibiotic sulphamides
- Macrolides
- Quinolones
Vaccines
Anaesthetics
- General (curares )
Aspirin and non-steroid anti-inflammatories
Miscellaneous
- Heparins
- Insulins
- Certain anti-retroviral drugs
- Paracetamol