Medication allergy

Apart from their desired effects, medications can also have undesired ones. These could be intolerances in which the metabolism does not break down a drug properly. A medication allergy occurs when the immune system responds defensively to the substance or other ingredients found in the medication.

People with medication allergies often do not know which medications are suitable for them and which are not. If a person is reliant on a particular medication, it can be difficult to find a suitable alternative. Sometimes, alternative medications are not as effective.

A medication allergy does not only trigger acute symptoms, it can also slow down the treatment of an illness.

Those who have an allergic reaction to a medication typically notice it within one hour of taking it (immediate reaction). However, there are medication allergies in which the reaction occurs later, sometimes many hours later, and sometimes even a few days or weeks later (delayed reaction).

An immediate reaction can manifest itself though the following symptoms:

• reddened skin and skin that feels hot to the touch
• patchy rashes
• itching
• mucosal swelling
• water retention in the tissue (edema)
• formation of hives (urticaria or nettle rash)

A severe reaction (anaphylactic shock) can result in shortness of breath, impaired consciousness, or even cardiovascular arrest. 

If the allergy does not appear immediately, the reaction typically appears within a few days. In rare cases, a delayed reaction may occur within a period of up to two weeks. It can lead to a rash and fever. Rarely, there are also severe reactions which result in severe swelling of the face, excessive peeling of the skin, or damage to organs.

To ensure that they receive the best possible medical care, people with a medication allergy can store details of their intolerances in the emergency data record on the electronic medical data card.

The most common triggers of a medication allergy are:

• antibiotics (often penicillin)
• medication for pain and rheumatism
• contrast agents (such as those used for x-rays)
• local anesthetic and other sedatives
• cancer drugs
• medications for treating epilepsy
• ACE inhibitors for treating high blood pressure
• medication to treat mental illnesses (psychotropic drugs such as antidepressants or neuroleptics)
• additives in medicinal products

Allergic reactions to medications also depend on how the substance is taken. A medication that is injected, administered as an infusion, or applied to the skin causes an allergic reaction more often than a medication that is taken orally. The risk of an allergic reaction is greatest with infusions through the veins.

Medication allergies are more common in young adults and middle-aged people than in children or the elderly. Women also experience allergic reactions more often than men. In addition, people with certain genetic alterations or viruses such as HIV/Aids are at a higher risk of an allergic reaction to a medication.

Many symptoms of a medication allergy can be mistaken for other side effects or symptoms of an illness. For example, rashes can also be a symptom of measles or rubella. Therefore, a medication allergy is not readily apparent from just its symptoms.

When diagnosing a medication allergy, doctors first ask the following questions:

• When and how did the symptoms appear?
• Which medications were taken?
• What was the dose?

It is important that people who take many medications, in particular, provide information that is as accurate as possible. Useful information about taking medication can also be found in health records or hospital discharge letters.

Not only those medications requiring prescriptions, but also over the counter medication, herbal remedies and dietary supplements can trigger an allergic reaction. Therefore, it is important to provide the doctor with this information as well. Tests are used to find out which substance and active ingredients are responsible for the allergy. Nevertheless, these tests do not always make diagnosis easy.

Those who have a medication allergy can often go without the active ingredient. However, a medication allergy cannot be cured by allergen immunotherapy for example.

Antiallergic drugs known as antihistamines or cortisone can help prevent allergic reactions. Adrenalin injections are used when a reaction is severe. If a person goes into anaphylactic shock, emergency services should be alerted immediately via the emergency number 112. 

Patients that know the medications they are allergic to can often find alternatives. If the medication is an antibiotic or painkiller, an alternative is usually available. The treating doctor can recommend a suitable alternative.

However, it is important to be aware of cross-reactions, because people with medication allergies can also have a reaction to similar substances.

But some medications are critical or cannot be simply replaced by an alternative. If an alternative is not available for an important treatment, doctors can administer the drug to the allergic patient in lower doses at first. The dose can be increased little by little under the supervision of a doctor. The goal is for the body to tolerate the medication for a certain amount of time. However, this approach does come with risks. It may be necessary for those with cancer or a serious infection.

Not every physical reaction to a medication is an allergy. For example, antibiotics can cause a rash; this is not necessarily an allergic reaction. Scientific studies have shown that some people incorrectly assume that they are allergic to a medication.

There are many people who believe that they or their children are allergic to penicillin. Often, an allergy test does not confirm this. These types of false assumptions can lead to problems. For example, if a patient is not treated with penicillin, but rather with a broad-spectrum antibiotic to fight against many different pathogens, resistant germs can form. Therefore, it is important to diagnose medication allergies accurately.