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16 Cards in this Set
- Front
- Back
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What is the difference between an allergy and pseudoallergy?
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Allergy = immune-mediated
Pseudoallergy = NOT immune-mediated; inflammatory mediators released by substance other than IgE (Anaphylactoid = anaphylaxis-like) |
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What are some examples of pseudoallergic reactions
1. Vancomycin 2. Niacin 3. Opiates 4. Iodinated contrast dye |
1. Vancomycin - Red Man Syndrome
2. Niacin - flushing 3. Opiates - pruritis 4. Iodinated contrast dye - shock |
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What are 4 questions to ask when evaluating drug allergies?
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1. Ask medication AND reaction
2. How long ago was the reaction? (PCN allergies can disappear in 5-10 yrs) 3. Ever taken same or similar med? 4. Food allergies |
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New data suggests cross-reactivity of beta-lactams is due to similar ____ _______, NOT ___-_____ ring.
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New data suggests cross-reactivity of beta-lactams is due to similar side chains, NOT beta-lactam ring.
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Do not give PCN and cephalosporins if:
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reaction to either was anaphylaxis, hives or angioedema
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Do not give carbapenem if:
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positive PCN skin test
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True or False: If patient has an allergy to PCN or aztreonam, a monolactam can be SAFELY administered to most patients.
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TRUE
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True or False: Allergies to sulfa, sulfur, sulfate and sulfite will likely be cross-reactive.
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FALSE: These are NOT the same and cross-reactivity is NOT likely.
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True or False: Patients with a sulfa antibiotic allergy were more likely to be allergic to PCN than a non-antibiotic sulfa.
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TRUE - do not trust package insert for this into. Be smarter than the computer in front of you!
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What is suggestive of an opioid PSEUDOallergy?
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-flushing, itching, sweating, mild hypotension, rxn at injection site only
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What is suggestive of a true opioid allergy?
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-severe hypotension, difficulty breathing, speaking, swallowing, swelling of the face, lips, tongue, mouth, etc...
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Opioid PSEUDOallergy
1. ___-____ analgesics 2. Avoid _______ > _______ > _______ 3. Prefer ______ > _______ > ______ > _______ 4. Concurrent administration of ________ 5. Dose ________ |
1. Non-opioid analgesics
2. Avoid meperidine > codeine > morphine 3. Prefer fetanyl > hydromorphone > oxycodone > hydrocodone 4. Concurrent administration of antihistamine 5. Dose reduction |
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Opioid Allergy
1. __-_____ analgesic 2. Choose opioid from a different class A. B. C. |
1. Non-opioid analgesic
2. Choose opioid from a different class A.Phenylpiperidine (meperidine, fentanyl/derivatives) B.Diphenylheptane (methadone, propoxyphene) C.Morphine (morphine, codeine, hydrocodone, oxycodone, oxymorphone, hydromorphone) |
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Aspirin/NSAIDs generally produce 2 types of reactions:
1. 2. Possibly related to: |
2 types of reactions:
1.urticaria/angioedema 2. rhinitis -> sinusitis -> asthma Possibly related to COX-1 blockade |
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Insulin
Large protein molecule is a complete __ Fewer reactions since replacement of ____ and ____ insulins |
Large protein molecule is a complete Ag
Fewer reactions since replacement of beef and pork insulins |
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Radiocontrast Dye
Anaphylactoid rxns may occur because of: NO cross-reactivity with: |
Anaphylactoid rxns may occur because of large, rapidly infused IV doses
NO cross-reactivity with seafood allergy |
