Understanding adverse drug reactions and drug allergies: Principles diagnosis and treatment aspects

Recent Patents on Inflammation and Allergy Drug Discovery

Volume 1 - Number

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Adverse Drug Reactions (ADRs) and drug allergies- as a subset of ADRs- make a significant public health concern, complicating 5 to 15% of therapeutic drug courses. They may result in diminished quality of life, increased physician visits, health care costs, hospitalizations, and even death. The incidence of serious ADRs in hospitalized patients was estimated to be 6.7% and for fatal ADRs to be 0.32%, so recognizing and taking action on ADRs is an important aspect of medication management. Allergic reactions to drugs refer to those ADRs that involve immune mechanisms which account up to 15% of ADRs and can be identified as being a type I through IV immune reaction that the most common immunologic mechanism is IgE-mediated- type I reaction. Clinical manifestations of allergic reactions range from pruritus and rash to serious reactions such as systemic anaphylaxis and cardiovascular emergencies and they are responsible for 2-3% of hospitalized patients. Health professionals should be aware of the ADRs presenting clinical features and the risk factors and should be able to differentiate between allergic and non-allergic adverse drug reactions. This will lead to increased opportunities to review drug selection and prescribing practices affecting patients outcome. This article will review the definition and estimated incidence, the features, classification and types of ADRs and drug allergies and related patents. It will highlight the role of detecting, reporting, and assessing suspected ADRs and drug allergies in the most clinically relevant drugs group. Priorities in the evaluation and management of the conditions of patients who have experienced allergic and non-allergic drug reactions also will be discussed. © 2008 Bentham Science Publishers Ltd.

Keyword: Adverse drug reaction (ADR) Adverse drug reaction reporting systems Basophil activation test (BAT) Beta-lactams Diagnostic tests Drug allergy Drug hypersensitivity Drug monitoring Immunologic desensitization Local anesthesia Non-steroidal anti-inflammatory agents Skin tests Sulfonamides abacavir acetylsalicylic acid adrenalin allopurinol aminopenicillin amoxicillin antibiotic agent anticoagulant agent antihistaminic agent beta lactam antibiotic carbamazepine cephalosporin derivative contrast medium corticosteroid cyclooxygenase 2 inhibitor cyclophosphamide erythromycin hydralazine immunoglobulin E local anesthetic agent methotrexate nonsteroid antiinflammatory agent paracetamol penicillamine penicillin G penicillin V primaquine sulfonamide theophylline unindexed drug allergic pneumonitis anaphylaxis angioneurotic edema aseptic meningitis asthma bladder carcinoma bleeding cardiovascular disease cause of death clinical feature consultation contact dermatitis delayed hypersensitivity diagnostic test disease classification DRESS syndrome drug cross reactivity drug eruption drug induced disease drug potentiation drug surveillance program erythroderma exfoliative dermatitis fixed drug eruption health care cost hemolytic anemia hospitalization human immediate type hypersensitivity immune response immunopathogenesis incidence liver toxicity maculopapular rash measles like rash penicillin allergy priority journal pruritus public health service pustulosis quality of life respiratory tract disease review risk assessment seizure skin manifestation Stevens Johnson syndrome systemic lupus erythematosus thrush tinnitus toxic epidermal necrolysis treatment planning urticaria xerostomia Humans Patents as Topic Pharmaceutical Preparations Risk Factors Treatment Outcome