4 Drug Allergies and Hypersensitivity
Learn how to distinguish medication side effects from possible drug allergy, respond to suspected hypersensitivity, recognize anaphylaxis, and document reactions accurately.
Distinguishing side effects from allergy
Drug allergies are immune-mediated reactions. An unwanted drug effect, such as nausea or dry mouth, does not by itself establish that a patient has an allergy.
Hives, itching, or swelling can suggest . Assess for additional symptoms and distinguish what the patient experienced from an established allergy label.
Responding to a possible mild reaction
For nausea after a first antibiotic dose, with no rash, itching, swelling, or breathing difficulty, nausea alone is more consistent with a than an allergic reaction. Assess the severity and related symptoms, document the experience, and communicate with the prescriber or pharmacist as appropriate. Do not label the patient allergic based on nausea alone; clarify and record the reaction accurately.
Managing isolated skin symptoms
If a patient develops a few itchy hives during an IV medication infusion but has no swelling, wheezing, throat symptoms, dizziness, or abnormal vital signs, stop the infusion and assess airway, breathing, circulation, and vital signs. Notify the prescriber, follow the facility’s reaction protocol, and continue observing for progression.
A prescribed may help isolated skin symptoms. Do not restart the medication unless specifically directed. Document the suspected drug, timing, symptoms, and actions taken.
Recognizing and treating
is an emergency that can involve breathing or circulation problems, sometimes without skin symptoms. Hoarseness, wheezing, widespread hives, and light-headedness developing minutes after a medication are signs of suspected that require an emergency response.
Stop the medication, activate emergency help, and give intramuscular promptly under the applicable emergency protocol or order. Support airway and breathing, provide oxygen and monitoring, and prepare for further emergency treatment. Do not delay to give an .
Position the patient lying down with legs elevated if tolerated. Adapt positioning if breathing difficulty or vomiting makes that unsafe.
Choosing the first medication
is the first-line treatment for . Antihistamines may relieve itching or hives, but they do not adequately treat dangerous airway or circulation problems and must not delay .
Do not withhold indicated because a patient has a history of heart disease or because of concern about palpitations or other cardiac effects. Give prompt intramuscular , monitor the patient, and continue emergency care according to protocol.
Documenting reactions accurately
For a suspected reaction, record the suspected drug and the reaction clearly. Include the timing, symptoms, and actions taken, and communicate with the prescriber or pharmacist as appropriate. Accurate documentation helps avoid labeling a patient allergic on the basis of a alone.