Anaphylaxis
Medications are widely used to treat diseases and eliminate problems that still
pose a threat to our health. However, sometimes our bodies react differently to
certain medications, leading to allergic reactions, known as "drug
allergy."
Drug allergy occurs in about 5% of people who take medication. It is important
to recognize the allergy before it is too late, as the symptoms of drug allergy
intensify with increased sensitivity.
Allergy is an immune system response to certain substances
(such as pollen, fungi, some foods, etc.). Normally, the immune system fights
harmful substances that enter the body, but in the case of allergies, it
mistakenly treats some substances as harmful by producing antibodies that cause
allergic symptoms.

Drug Allergy
Drug allergy is a negative reaction to a medication that
affects your body. This happens due to the immune system's response to the
drug, which it perceives as an enemy and reacts to it. As a result, you may
develop an allergy that lasts for a few days until the drug's effects wear off.
There is a difference between the side effects of a drug and an actual allergy
to the drug. People usually experience drug side effects, but only about 5-10%
of people actually suffer from drug allergies.
Symptoms of Drug Allergy
Drug allergies have some clear symptoms in the affected
person, which may include:
- Skin rashes
- Sudden high fever that lasts
for several days
- Difficulty breathing
- Behavioral changes
- Irritation and itching
Risks of Drug Allergy
In most cases, drug allergies do not cause significant harm
or risks to health. However, a person may become allergic to a particular
medication, and the situation could worsen. If not treated promptly and
symptoms continue to escalate, it can affect other organs and bodily functions.
Severe drug allergies can lead to life-threatening complications. For example,
anaphylaxis is a sudden allergic reaction that occurs in the body due to a drug
or allergen entering the system. Due to this allergy, another reaction occurs
in the body after taking the drug, which can lead to various heart and
respiratory issues.
Drugs That Can Cause Allergies
It depends on the individual, as different people may be
allergic to different types of medications. However, there are some drugs that
people are commonly allergic to:
- Antibiotics, such as penicillin
or sulfa-based antibiotics commonly used in medicine.
- Aspirin, which is widely used
but can also cause drug allergies.
- Chemotherapy drugs.
- Dyes used in X-rays.
- Some non-steroidal
anti-inflammatory drugs (NSAIDs) that are widely consumed.
- Drugs containing antibody-based
treatments.
Definition of Anaphylactic Shock
(Hypersensitivity):
Anaphylactic shock is a severe allergic reaction that can
impair breathing, cause a significant drop in blood pressure, and affect the
heart rate. It may appear within minutes of exposure to the allergen.
Allergy Triggers:
- Some foods (e.g., eggs, nuts,
fish, certain fruits, etc.).
- Insect stings (e.g., bees,
etc.).
- Latex allergy (used in gloves,
balloons, erasers, rubber balls, some lab tubes and stoppers, etc.).
- Some medications, like
antibiotics and aspirin.
- Certain substances used in
medical tests, such as the dye used in radiology procedures.
Signs of Anaphylactic Shock:
- Swelling of the lips, tongue,
face, or eyes.
- Rapid heart rate.
- Swelling and tightness in the
throat.
- Difficulty breathing and
speaking.
- Skin rash, vomiting, or
abdominal pain.
- Dizziness, fainting, or loss of
consciousness.
Treatment:
Anaphylaxis is an emergency condition that can be
life-threatening. If someone exhibits symptoms of anaphylaxis, the following
steps should be taken:
- Discontinue the medication: If the doctor determines an allergy to a medication or
a potential allergy, the first step is to stop using that drug. This may
be the only necessary intervention in many cases.
- Antihistamines: The doctor may prescribe an antihistamine or recommend
an over-the-counter antihistamine, such as diphenhydramine (Benadryl).
Antihistamines prevent the immune system from releasing certain chemicals
during an allergic reaction.
- Corticosteroids: Corticosteroids may be taken orally or through
injection to treat inflammation caused by more severe reactions.
- Anaphylactic Shock Treatment: Anaphylactic shock requires immediate injection of
epinephrine (adrenaline). Hospital care is also necessary to maintain
blood pressure and support breathing.
- Epinephrine Injection: The person should be injected with an epinephrine
injection (epinephrine) as per the doctor’s instructions.
- Immediate reporting to a
doctor.
- Administering antihistamines
according to the doctor's instructions.
- Removing the allergen (e.g.,
any insect residue stuck to the skin if it caused the sting).
- Laying the person on their back
and elevating their legs unless they are having difficulty breathing and
need to sit up to help with breathing. If the person is pregnant, they
should lie on their left side.
Epinephrine Injection:
This is a pre-filled self-injection containing adrenaline
(epinephrine), specifically for immediate treatment during a severe allergic
reaction (anaphylaxis) in patients who are at risk. Each injection contains one
dose (one-time use) of epinephrine, which is discarded after use.
Conditions That Require Epinephrine Injections:
- Patients with anaphylaxis due
to:
- Insect stings (e.g., bee,
wasp, fire ants).
- Certain foods.
- Diagnostic test substances
(e.g., radiology dye) and other allergens.
- Idiopathic anaphylaxis
(unknown cause).
- Exercise-induced anaphylaxis.
Precautions Before Taking the Injection:
You should inform the doctor in the following medical
conditions:
- If the patient is allergic to
the injection or any of its components.
- If the patient has any of the
following health problems: heart problems, high blood pressure, diabetes,
thyroid issues, glaucoma, asthma, depression, Parkinson’s disease, kidney
or prostate problems.
General Guidelines:
- It is crucial to know your
allergens and avoid them.
- The injection is given into the
middle of the outer thigh.
- Do not inject it into veins,
hands, or feet. If accidentally injected in any other part of the body,
seek emergency medical care immediately.
- Ensure the legs of a child are
stabilized to limit movement during the injection.
- The injection should be
regularly checked to ensure the solution isn’t pink, brown, cloudy, or
contains particles.
- Epinephrine is sensitive to
light and should be stored in its protective outer container to shield it
from light.
- Avoid exposing the syringe to
extreme cold or heat. Store it away from direct sunlight.
- The syringe is for single-use
only.
- Do not reuse the remaining
liquid from the syringe.
- Recognize the symptoms of an
allergic reaction and know what to do in an emergency.
- Report to the doctor if any
signs of infection (e.g., persistent redness, warmth, swelling) are
observed at the injection site.
- Symptoms such as an increased
heart rate, sweating, nausea, vomiting, pale skin, dizziness, or headaches
may occur, but they usually subside with rest.
Drug Allergy Test

- Simple hand washing
- Preparation of tools and
equipment: Alcohol wipe, ballpoint pen,
latex gloves, 10cc syringe, insulin syringe, prescribed medication
- Explain the procedure to the
patient
- Maintain patient privacy
- Wash hands thoroughly and wear
latex gloves
- Clean the test site with
alcohol
- Draw small marks on the skin
and place a drop of the allergen extract next to each mark, then wipe them
off
- This type of test uses very
fine needles that barely penetrate the skin surface
- There will be no bleeding, but
temporary discomfort may be felt, and a small bubble may form on the skin
- The results will appear within
15 minutes
- If the patient is allergic to
any of the substances being tested, a raised red and itchy bump will
develop
- The skin prick test (SPT) is
globally accepted and recommended as the first step in diagnosing
allergies, as it is safe, easy, time-efficient, and will not trigger
significant allergic reactions
- Perform subcutaneous injection
steps at a 45-degree angle for a 3cc syringe and horizontally for an
insulin syringe
- When injecting, only 1ml of the
medication to be tested is injected
- Mark the area around the
injection site
- Observe the injection site for
10 minutes after injection
- Report to the doctor if any
reaction occurs (redness, swelling, or tendency to itch)
- Record this on the patient's
ticket and allergy card
- Prepare the syringe with the
medication to be administered and inject the patient if no reaction occurs
- Complete the remaining steps as
usual for subcutaneous injection.
