药物过敏

什么是药物过敏?

A drug allergy is due to a specific and reproducible immune response to a particular medication.  Some drug allergies carry a risk of "allergic shock" or anaphylaxis if the medication is taken again.  还有其他类型的免疫反应具有不同的风险.  皮疹在许多类型的药物过敏中都很常见.

药物过敏和其他药物反应有什么区别?

药物过敏是一种严重的药物不良反应.  These are dangerous reactions, and medication and related substances need to be avoided.  不耐症不那么严重，不涉及免疫系统.  在这些情况下, 尽管效果是不可取的, 他们可能值得服用药物所带来的好处.  Drug intolerance reactions may respond to dose reduction or taking a different but related medication.  如果你真的对药物过敏，这些行为可能是危险的.

药物过敏有多常见?

只有5- 10%的药物不良反应是药物过敏.

导致药物过敏的原因?

Acute or rapid drug allergies are generally due to allergic antibodies (IgEs) to the drug in question.  Interactions between the problem drug and allergic antibodies (IgE) cause the allergic reaction by releasing histamine and other inflammatory chemicals.  This cascade causes allergy symptoms that can range from uncomfortable to life threatening such as hives, 肿胀, 呼吸困难, 呕吐, 甚至过敏反应(“过敏性休克”)，如果再次服用药物.

There are other types of immune reactions that work on different pathways and result in different reactions.

哪些药物最常与药物过敏相关?

任何药物都可能引起药物过敏，但有些更有可能.  Drug allergies to antibiotics including penicillin and related medications are the most common.  Many people are allergic to aspirin and related drugs called NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen or naproxen.  抗癫痫药物会引起严重的药物不良反应.   一定要咨询你的医生和药剂师关于潜在的药物过敏. 

药物过敏的症状是什么?

皮疹是最常见的症状. The symptoms and severity of drug allergy reactions can vary from person to person and also depend on the specific medication(s) you are taking.  一定要向医生咨询诊断.  以下列出了一些常见症状:

• 皮疹包括凸起或扁平的皮肤颜色变化
• 荨麻疹，或发痒，隆起的肿块
• 肿胀皮肤或嘴巴肿胀
• 喉咙发紧或声音嘶哑
• 呼吸困难或喘息

Severe reactions such as anaphylaxis are medical emergencies and are treated with epinephrine.  拨打911 立即获得医疗援助. 

我以前吃过很多次的药会不会过敏?

是的, repeatedly taking the same medication for limited periods of time actually increases the likelihood of a drug allergy.  例如，有些人会对抗生素产生药物过敏.

人长大后能摆脱药物过敏吗?

药物过敏会随着时间而改变.  事实上, 许多, but not all people with a documented drug allergy to penicillin outgrow this allergy after 10 years.  其他药物过敏被认为是终身的.  如果你想知道药物过敏的状况，和你的医生讨论一下.

如何诊断药物过敏?

The most important tool to diagnose a drug allergy is a discussion with your doctor about the exact details of the reaction and a detailed physical exam.  If you are not able to see your doctor right away, take pictures of the rash or other problem.

不幸的是, there are very few good tools to help us identify drug allergies and it can be difficult to identify which drug is responsible for a rash or other problem.  对于某些药物，皮肤测试或实验室测试可能会有所帮助.  有时，需要转介皮肤科医生进行皮肤活检.  Other times a closely monitored drug challenge is needed to determine if an allergy is present.

我可以做青霉素过敏测试吗?

幸运的是，有一个很好的青霉素过敏测试.  这是一种皮肤试验，首先用药物刺破皮肤的顶层.  If this does not show a reaction, injections of the medication are then placed under the skin.  如果没有反应，那么你就不再过敏了.  The reason that penicillin skin testing is an effective test is that all of the important metabolites have been identified.  This means that the penicillin skin test can correctly identify not only who is allergic to penicillin, 而且谁也不过敏.

什么是药物挑战?

Graded dose drug challenges are performed when drug allergy testing is unlikely to prove that you are not allergic to a medication.  在监控设置中, increasing amounts of the medication in question are given by doctors and nurses skilled at recognizing and treating allergic reactions.

药物挑战是如何运作的?

我们在住院和门诊环境中提供药物挑战. The drug challenge is generally performed only if medically acceptable alternatives do not exist and only when any other concurrent health issue is under optimal control.

This is a >4 hour procedure involving the administration of a carefully monitored test dose in one or more steps.The challenge procedure starts with tiny doses of the medication that we gradually increase to the goal dose. 病人会有什么反应吗, 我们会停止药物治疗，进行支持性治疗.

药物过敏有什么治疗方法?

避免是防止反应的唯一方法.  告诉医生和药剂师你的药物过敏是很重要的.   You should carry identifying information about serious drug allergies such as a card in your wallet or a bracelet.  Accidental exposures to the medication in question should be treated immediately with the appropriate medications.

有时，你过敏的药物可能是治疗你病情的最佳方法.  Depending on your prior reaction, you may be able to undergo a drug desensitization procedure.

什么是药物脱敏?

对于某些类型的药物过敏, a drug desensitization procedure can temporarily allow you to tolerate a medication you are allergic to, 特别是如果你真的需要这种药.  安全操作, this procedure must be closely supervised by experienced allergists with the help of nurses and pharmacists.  它包括从小剂量的药物开始, 慢慢地加倍剂量，直到服用完全部剂量.  如果有任何过敏的迹象，暂时停止脱敏, 反应被处理了.  当你从反应中恢复过来时，脱敏又开始了.

目前还不完全清楚为什么会这样, 但这个过程似乎使过敏细胞“无反应”.“脱敏不是一种治疗方法, but does allow temporary use of the medication as long as it is given at least once a day.  如果你停药一天或更长时间，这个过程必须重复.  一个典型的程序需要几个小时到几天才能完成，大多数反应是轻微的.

药物脱敏是如何起作用的?

我们提供药物脱敏在住院和门诊设置. Drug desensitization is generally performed only if medically acceptable alternatives do not exist and only when any other concurrent health issue is under optimal control.

This is a >4 hour procedure that allows a patient who is allergic to a medication to temporarily tolerate the medication when it is medically necessary. 脱敏过程从小剂量的药物开始, 我们逐渐增加药量达到目标剂量, treating any signs and symptoms of an allergic reaction as it occurs with supportive therapies. 在手术结束时, the temporary tolerance will remain as long as the patient continues to receive the medication regularly. 如果药物使用中断, an allergy evaluation is needed as the patient will need a repeat desensitization procedure.