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Drug allergies
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Drug allergies are a group of symptoms caused by an allergic reaction to a drug (medication).

Causes
Adverse reactions to drugs are common, and almost any drug can cause an adverse reaction.
Reactions range from irritating or mild side effects such as nausea and vomiting to life-
threatening anaphylaxis.

A true drug allergy results from a series of chemical steps within the body that produce
the allergic reaction to a medication.

It can develop two different ways:

1. The first time you take the medicine, you have no problems, but your body's immune
system produces a substance (antibody) called IgE against that drug. The next time you
take the drug, the IgE tells your white blood cells to make a chemical called histamine,
which causes your allergy symptoms.
2. A drug allergy may also occur without your body producing IgE, but this is not well
understood.

Most drug allergies cause minor skin rashes and hives. Serum sickness is a delayed type of drug
allergy that occurs a week or more after exposure to a medication or vaccine.

Penicillin and related antibiotics are the most common cause of drug allergies. Other
common allergy-causingdrugs include:

 Sulfa drugs
 Anticonvulsants
 Insulin preparations (particularly animal sources of insulin)
 Iodinated (containing iodine) x-ray contrast dyes (these can cause allergy-like
anaphylactoid reactions)

Most side effects of drugs are not due to an allergic reaction. For example, aspirin can cause
nonallergic hivesor trigger asthma. Some drug reactions are considered "idiosyncratic." This
means the reaction is an unusual effect of the medication, not due to a predictable chemical
effect of the drug. Many people confuse an uncomfortable, but not serious, side effect of a
medicine (such as nausea) with a true drug allergy, which can be life threatening.

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What causes a drug allergy?
 An allergic reaction occurs when the body's immune system produces antibodies and activates
disease-fighting cells in response to an offending substance in the environment - in this case, a
specific drug.

The antibodies release chemicals that injure the surrounding cells and cause the physical
symptoms of an allergic reaction. Certain specialized cells in the skin and mucous membranes
release chemicals known ashistamines.

In the first step of drug allergy development, the body becomes sensitized (i.e., the immune
system is triggered) by the first exposure to the medication. A subsequent exposure causes an
immune response, including the production of antibodies and release of histamine. Therefore,
drug allergy reactions occur after a person has been previously exposed to the drug one or
more times without any allergic reaction.

Drug allergies may be due to the direct effects of a medication, as occurs with penicillin,
vaccines, blood transfusions, insulin and intravenous (IV) fluids. These medications involve the
body's immune system directly.

Other drug allergies may be caused indirectly by medications that do not involve the immune
system but trigger histamine release in the body. Medications such as ASA and anti-
inflammatory drugs, morphine and related medications (known as opiates), local anesthetics,
and some fluids given intravenously during X-rays can indirectly cause drug allergies.

In general, the number and severity of adverse reactions increase as the dose increases.
However, this relationship doesn't apply to people who are allergic to a medication. For these
people, even small amounts of the medication can trigger an allergic reaction, which can range
from minor and simply annoying to severe and life threatening.

In theory, all medications can cause allergic drug reactions. Some common medications that
have been associated with allergic reactions include:

 antibiotics such as penicillin, cephalosporins, and sulphonamides

 blood pressure medications such as ACE inhibitors
 opiates such as codeine and morphine
 non-steroidal anti-inflammatory drugs (ASA-like drugs) such as ibuprofen and
indomethacin

http://www.emedicinehealth.com/drug_allergy/page2_em.htm

Drug Allergy Causes

An allergic reaction is caused by the body'simmune system overreacting to the drug, which is
viewed as a chemical "invader," or antigen. This overreaction is often called a hypersensitivity
reaction.

 The body produces antibodies to the antigen and stores the antibodies on special cells.
o The antibody in an allergic reaction is called immunoglobulin E, or IgE.
 o When the body is exposed to the drug again, the antibodies signal the cells to release
chemicals called "mediators."Histamine is an example of a mediator.

o The effects of these mediators on organs and other cells cause the symptoms of the
reaction.

 The most common triggers of drug allergies are the following:

o Painkillers (called analgesics) such ascodeine, morphine, nonsteroidal antiinflammatory
drugs (NSAIDs, such as ibuprofen or indomethacin), andaspirin

o Antibiotics such as penicillin, sulfa drugs, and tetracycline

o Antiseizure medications such as phenytoin (Dilantin) or carbamazepine(Tegretol)

 Risk factors for drug allergies include the following:

o Frequent exposure to the drug

o Large doses of the drug

o Drug given by injection rather than pill

o Family tendency to develop allergies andasthma

o Certain food allergies such as to eggs, soybeans, or shellfish