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3 Drug hypersensitivity Thien FCMed J Aust 2006[Sep]; 185 (6): 333-8Most drug reactions are pharmacological reactions rather than hypersensitivity reactions. In assessing drug reactions, a detailed clinical history and careful documentation of reactions are most important. Elucidating the nature and time course (first versus subsequent exposure, immediate versus non-immediate) of a reaction can help to distinguish immune from non-immune hypersensitivity, as well as IgE-mediated from T cell-mediated allergy. Skin testing and in-vitro tests are of predictive value for only a limited group of IgE-mediated drug allergic reactions. Drug provocation challenges can be used to eliminate suspicion of a low-probability drug reaction, find a safe alternative to a proven or probable drug reaction, or as a means of desensitisation. If a patient taking an angiotensin-converting enzyme (ACE) inhibitor develops angioedema, the cause must be assumed to be the ACE inhibitor until proven otherwise.|Angioedema/chemically induced[MESH]|Angiotensin-Converting Enzyme Inhibitors/adverse effects[MESH]|Clinical Competence[MESH]|Drug Hypersensitivity/*diagnosis/immunology/*prevention & control[MESH]|Humans[MESH]|Hypersensitivity, Delayed/diagnosis/immunology/prevention & control[MESH]|Hypersensitivity, Immediate/diagnosis/immunology/prevention & control[MESH]|Immunologic Tests/methods[MESH]|Medical History Taking[MESH]|Practice Guidelines as Topic[MESH]|Skin Tests/methods[MESH] |
