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16 Cards in this Set

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What is the difference between an allergy and pseudoallergy?
Allergy = immune-mediated

Pseudoallergy = NOT immune-mediated; inflammatory mediators released by substance other than IgE
(Anaphylactoid = anaphylaxis-like)
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
What are 4 questions to ask when evaluating drug allergies?
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
New data suggests cross-reactivity of beta-lactams is due to similar ____ _______, NOT ___-_____ ring.
New data suggests cross-reactivity of beta-lactams is due to similar side chains, NOT beta-lactam ring.
Do not give PCN and cephalosporins if:
reaction to either was anaphylaxis, hives or angioedema
Do not give carbapenem if:
positive PCN skin test
True or False: If patient has an allergy to PCN or aztreonam, a monolactam can be SAFELY administered to most patients.
TRUE
True or False: Allergies to sulfa, sulfur, sulfate and sulfite will likely be cross-reactive.
FALSE: These are NOT the same and cross-reactivity is NOT likely.
True or False: Patients with a sulfa antibiotic allergy were more likely to be allergic to PCN than a non-antibiotic sulfa.
TRUE - do not trust package insert for this into. Be smarter than the computer in front of you!
What is suggestive of an opioid PSEUDOallergy?
-flushing, itching, sweating, mild hypotension, rxn at injection site only
What is suggestive of a true opioid allergy?
-severe hypotension, difficulty breathing, speaking, swallowing, swelling of the face, lips, tongue, mouth, etc...
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
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)
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
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
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