Acute symptoms of drug hypersensitivity (urticaria, angioedema, anaphylaxis, anaphylactic shock)

• Published in: The Medical clinics of North America Vol. 94; no. 4; p. 691
• Main Authors: Limsuwan, Ticha, Demoly, Pascal
• Format: Journal Article
• Language: English
• Published: United States 01.07.2010
• Subjects: Adrenergic Agonists - therapeutic use; Anaphylaxis - chemically induced; Anaphylaxis - diagnosis; Anaphylaxis - drug therapy; Angioedema - chemically induced; Angioedema - diagnosis; Angioedema - drug therapy; Diagnosis, Differential; Drug Hypersensitivity - complications; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - drug therapy; Drug-Related Side Effects and Adverse Reactions; Epinephrine - therapeutic use; Humans; Risk Factors; Sympathomimetics - therapeutic use; Urticaria - chemically induced; Urticaria - diagnosis; Urticaria - drug therapy
• ISSN: 1557-9859
• DOI: 10.1016/j.mcna.2010.03.007

Drug hypersensitivity reactions (HSRs) are the adverse effects of drugs which, when taken at doses generally tolerated by normal subjects, clinically resemble allergy. Immediate-reaction of drug HSRs are those that occur less than 1 hour after the last drug intake, usually in the form of urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, and anaphylaxis or anaphylactic shock. Acute urticarial and angioedema reactions are common clinical problems frequently encountered by internists and general practitioners. They are not specific to drug allergic reaction, and can be caused by various pathogenic mechanisms. Despite the benign course of urticaria and angioedema, a mucocutaneous swelling of the upper respiratory tract could be life-threatening by itself or a feature of anaphylaxis. This article reviews acute symptoms of drug HSR-related urticaria, angioedema, anaphylaxis, and anaphylactic shock, and how clinicians should approach these problems.