Abstract
İlaç alerjileri ani ortaya çıkan ve hayatı tehdit edebilen reaksiyonlar olup tüm istenmeyen ilaç reaksiyonlarının %10-15’ini oluşturmaktadır. Klinik pratikte, aileler çocuklarında ortaya çıkan çeşitli istenmeyen ilaç reaksiyonlarını ilaç alerjisi olarak bildirebilmektedir. Hekimler ise çoğu zaman tanısal testler yapmadan sadece klinik öyküye ve hasta ya da hasta yakınının beyanına dayalı olarak ilaç alerjisi tanısı koymaktadır. Dolayısıyla, sadece ilaç alerjisi şüphesi çoğu zaman gereksiz ilaç alerjisi tanısının konulmasına ve tedavide daha pahalı, daha az etkin, yan etkisi daha fazla ilaçların reçete edilmesine neden olmaktadır. İlaç alerjisi şüphesi olan hastalarda ilaç alerjisi tanısı konulabilmesi için öncelikle detaylı öykü alınmalıdır. Öykü ile ilaç alerjisi dışlanamayan hastalarda deri testleri ve in vitro testler ile tanı konulmaya çalışılmalıdır. Bu testlerin negatif olduğu veya yapılmasının mümkün olmadığı hastalarda kontrendikasyon yok ise tanı için altın standart olan ilaç provokasyon testi yapılmalıdır.
References
- Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol 2005;5:309-16.
- Schnyder B. Approach to the patient with drug allergy. Med Clin North Am 2010; 94:665-79.
- Borch JE, Andersen KE, Bindslev-Jensen C. The prevalence of suspected and challenge-verifi ed penicillin allergy in a university hospital population. Basic Clin Pharmacol Toxicol 2006;98:357-62.
- Sade K, Holtzer I, Levo Y, Kivity S. The economic burden of antibiotic treatment of penicillin-allergic patients in internal medicine wards of a general tertiary care hospital. Clin Exp Allergy 2003;33:501-6.
Abstract
Drug allergies are serious acute and potentially life-threatening reactions that constitute 10-15% of all drug-related adverse reactions. In clinical practice, parents may wrongly report various adverse drug reactions their children experienced as a drug allergy. Physicians often make the diagnosis of a drug allergy based on patient or caregiver accounts rather than standard diagnostic tests. Thus, only a suspicion of a drug allergy is usually enough to make a diagnosis and to prescribe an alternative drug that is generally more expensive and less effective, with more potential side effects. A detailed clinical history of the reaction should be the fi rst step in patients with a suspicion of drug allergy. If the drug allergy cannot be excluded with the clinical history, skin tests and further in vitro tests should be performed. In patients in whom these tests are not informative or not available, a drug allergy diagnosis should be made with a drug provocation test, the gold standard, unless there is a contraindication
References
- Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol 2005;5:309-16.
- Schnyder B. Approach to the patient with drug allergy. Med Clin North Am 2010; 94:665-79.
- Borch JE, Andersen KE, Bindslev-Jensen C. The prevalence of suspected and challenge-verifi ed penicillin allergy in a university hospital population. Basic Clin Pharmacol Toxicol 2006;98:357-62.
- Sade K, Holtzer I, Levo Y, Kivity S. The economic burden of antibiotic treatment of penicillin-allergic patients in internal medicine wards of a general tertiary care hospital. Clin Exp Allergy 2003;33:501-6.
Details
| Other ID | JA54SE52NA |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 1, 2015 |
| Submission Date | April 1, 2015 |
| Published in Issue | Year 2015 Volume: 9 Issue: 1 |
The publication language of Turkish Journal of Pediatric Disease is English.
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