Drug hypersensitivity reactions

Research output: Chapter

1 Citation (Scopus)

Abstract

Adverse reactions caused by drugs can be divided into two main groups, type A and type B reactions. Type A reactions represent nearly 80 %-85 % of these side effects and are caused by predictable pharmacological actions of the drug, while type B reactions develop on the basis of individual predisposition (idiosyncratic reactions, immune-mediated and nonimmune-mediated hypersensitivity reactions) and account for 15 %-20 % of adverse effects. The skin is the organ most commonly, but not exclusively, affected in drug hypersensitivity reactions both in the immune-mediated (allergic) and in the nonimmune-mediated (pseudoallergic) forms; these reactions are observed in 2 %-3 % of hospitalised patients. Immune-mediated drug hypersensitivity reactions comprise a heterogeneous group of diseases which can be classified according to Gell and Coombs (antibody-mediated drug hypersensitivity reactions: type I, IgE; type II and III, IgG; and type IV, T cell mediated). After better understanding of T-cell functions and discovery of subgroups, the late type IV reaction has been further subdivided in the revised form of Gell and Coombs classification (type IVa, T helper 1; type IVb, T helper 2; type IVc, T cytotoxic mediated and type IVd). Nonimmune-mediated hypersensitivity reactions are the so-called pseudoallergic reactions, which usually imitate IgE-mediated reactions with wheal and oedema formation, but sometimes anaphylaxis can also develop. These pseudoallergic reactions tend to arise less rapidly than true IgE-mediated allergies, they require higher doses of the drugs and neither IgE nor T-cell reactions can be demonstrated later. Non-specific histamine release, arachidonic acid pathway activation, bradykinin pathway alteration and complement activation can be detected in the background. Nonsteroidal anti-inflammatory drugs (NSAIDs), plasma expanders and radiocontrast media are the most common causes of pseudoallergic reactions.

Original languageEnglish
Title of host publicationEuropean Handbook of Dermatological Treatments, Third Edition
PublisherSpringer Berlin Heidelberg
Pages219-231
Number of pages13
ISBN (Print)9783662451397, 9783662451380
DOIs
Publication statusPublished - jan. 1 2015

Fingerprint

Drug Hypersensitivity
Immunoglobulin E
Hypersensitivity
T-Lymphocytes
Gels
Pharmaceutical Preparations
Complement Activation
Histamine Release
Bradykinin
Anaphylaxis
Drug-Related Side Effects and Adverse Reactions
Arachidonic Acid
Contrast Media
Edema
Anti-Inflammatory Agents
Immunoglobulin G
Pharmacology
Skin
Antibodies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Szegedi, A., & Remenyik, E. (2015). Drug hypersensitivity reactions. In European Handbook of Dermatological Treatments, Third Edition (pp. 219-231). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-662-45139-7_22

Drug hypersensitivity reactions. / Szegedi, A.; Remenyik, E.

European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg, 2015. p. 219-231.

Research output: Chapter

Szegedi, A & Remenyik, E 2015, Drug hypersensitivity reactions. in European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg, pp. 219-231. https://doi.org/10.1007/978-3-662-45139-7_22
Szegedi A, Remenyik E. Drug hypersensitivity reactions. In European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg. 2015. p. 219-231 https://doi.org/10.1007/978-3-662-45139-7_22
Szegedi, A. ; Remenyik, E. / Drug hypersensitivity reactions. European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg, 2015. pp. 219-231
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