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Drug Allergy

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Basic Knowledge of Pharmacology

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Abstract

Drugs and pharmaceutical excipients contained in medicines can cause allergic reactions that are potentially life-threatening. Type I reactions are the result of mast cell degranulation and can lead to anaphylactic shock and death within a very short period of time. I.v. epinephrine (EPI) injection by the physician or the i.m. EPI injection by the patient (auto-injector) constitute the most important therapeutic measures. Type II reactions are characterized by immunologically mediated destruction of blood cells. Type III reactions are characterized by immune complex deposits that result in rheumatic symptoms. In type IV reactions, the HLA system is dysregulated, resulting in clinically heterogeneous autoimmunological reactions. SJS and TEN are particularly dangerous. Certain HLA polymorphisms predispose for type IV reactions.

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Further Reading

  • Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T (2018) Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis. Clin Rev. Allergy Immunol 54:147–176

    Article  CAS  Google Scholar 

  • Marone G, Stellato C, Mastronardi P, Mazzarella B (1993) Mechanisms of activation of human mast cells and basophils by general anesthetic drugs. Ann Fr Anesth Reanim 12:116–125

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  • Ring J, Klimek L, Worm M (2018) Adrenaline in the acute treatment of anaphylaxis. Dtsch Artzebl Int 115:528–534

    Google Scholar 

  • Tangamornsuksan W, Lohitnavy O, Kongkaew C, Chaiyakunapruk N, Reisfeld B, Scholfield NC, Lohitnavy M (2015) Association of HLA-B∗5701 genotypes and abacavir-induced hypersensitivity reaction: a systematic review and meta-analysis. J Pharm Pharm Sci 18:68–76

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Institute of Pharmacology, Hannover Medical School, Hannover, Germany

    Roland Seifert

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  1. Roland Seifert
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Seifert, R. (2019). Drug Allergy. In: Basic Knowledge of Pharmacology. Springer, Cham. https://doi.org/10.1007/978-3-030-18899-3_3

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