Xinhuanet, Beijing, April 28 (Pi Chen) Modern medicine is developing rapidly, and drugs have brought great progress to humans in treating diseases, but at the same time, an "invisible risk" also exists quietly, that is, drug allergies. It can be a slight rash itch, or it can cause shock or even life-threatening in a short period of time.

Xinhuanet Health Channel launched the "Allness Series Popular Science". This issue interviewed Wang Zixi, deputy chief physician of the Allergy Department of Peking Union Medical College Hospital, to comprehensively analyze the essence of drug allergy, common misunderstandings and scientific response strategies for the public.

Allergies in medication are not just "discomfortable"

"Adverse Drug Reactions" are a general term for discomfort reactions that occur after medication, and only a small number of them are real drug allergies. Wang Zixi pointed out that the core of drug allergy lies in abnormal reactions of the immune system: the body misidentifies certain components or their metabolites in the drug as "enemy", which in turn produces specific antibodies or cellular immune responses, causing various symptoms.

Any drug may theoretically cause allergies, but the following categories have higher risks:

(1) Antibiotics: especially β-lactams such as penicillin and cephalosporin;

(2) Antipyretic analgesics: such as ibuprofen, acetaminophen, etc.;

(3) Anesthetics and perioperative medications: including muscle relaxants and inducers;

(4) Traditional Chinese medicine injections: widely used in my country, and the risk for patients with pollen allergies is often relatively higher.

What are the "alarm signals" of drug allergy?

The symptoms of drug allergies vary from person to person and can occur quickly or may lag for several days or even more than a week. Wang Zixi pointed out that skin symptoms are the most common, and about 80% of patients with drug allergies will experience skin symptoms, including edema on the face, eyelids, lips or limbs, itchy skin, wind mass, rash, desquamation, and effusion throughout the body; in addition, it can also affect other systems of the body:

(1) Respiratory symptoms, such as cough, wheezing, laryngeal edema, shortness of breath;

(2) Digestive system reactions, such as nausea, diarrhea, and abdominal pain;

(3) Severely ill people may experience hypotension, shock, or even multiple organ dysfunction.

How to judge and record drug allergic reactions? These details cannot be ignored

"Diagnosing drug allergies does not depend on the doctor to simply prescribe a test form, nor does it rely solely on the patient's subjective feelings, but requires a comprehensive judgment through detailed consultation." Wang Zixi emphasized that if a patient has suspected allergic reactions after using the drug, he should seek medical treatment as soon as possible and do the following:

1. Record the common name of the drug (non-trade name): there may be multiple brands of the same ingredient;
2. Determine the time and attack time of medication: whether it is an immediate reaction or delayed for several hours or days;
3. Describe specific symptoms: location of the rash, whether it is accompanied by fever, whether it is accompanied by wheezing, gastrointestinal discomfort, etc.;
4. Keep diagnosis and treatment records: such as emergency records, medical records for medical treatment in the drug department, etc.
5. Take the initiative to inform your doctor about your allergy history: especially before surgery or when changing medications.

"A patient told me 'I am allergic to more than a dozen drugs'. After detailed review, it was found that most of these drugs contain the same ingredients, not multiple allergies at all, but unclear information records."

What should ordinary people pay attention to before taking medicine? These groups of people should be especially careful

Wang Zixi reminds that people with a history of allergies or family allergies should pay special attention before taking the medicine and explain the situation to the doctor in advance to evaluate whether alternative drugs are needed or prevention is prevented in advance.

(1) Pregnant women, children, and the elderly: the skin barrier is weak and the body is more sensitive. The medication should be monitored with caution;

(2) People who have experienced severe allergic reactions: patients with allergic shock or laryngeal edema should be highly vigilant;

(2) People with specific drugs allergic to the family: such as carbamazepine and allopurinol allergic, have certain genetic risks, and some people may consider HLA gene screening.

"We are not trying to prevent everyone from taking medicine, but we should be rational about risks and avoid underestimating and misjudging."

Common misunderstandings: If you have used it before, you won’t be allergic? Can't get vaccinated if you are allergic to seafood?

"Many people have misunderstandings about drug allergy." Wang Zixi clarified:

Misconception 1: I won’t be allergic if I have taken this medicine before

wrong! Drug allergies require a sensitization process. If you don’t have allergies for the first time, it does not mean you won’t be able to do so in the future.

Misconception 2: Can't inject CT enhancement contrast agent when you are allergic to seafood

The components and mechanisms of allergies between the two are completely different, and there is no clear relationship and cannot be generalized.

Misconception 3: If the symptoms are mild, you don’t need to seek medical treatment

Even if the rash is mild, it may be a precursor to serious reactions and medical evaluation is recommended.

"Fear is not a solution. Rational judgment and scientific records are the key to protecting oneself."

From diagnosis to treatment, the "new weapon" of drug allergy departments

In the era of precision medicine, the diagnosis and treatment of drug allergies are also constantly improving. Wang Zixi introduced that the Allergic Department of Peking Union Medical College Hospital has established a complete perioperative drug screening body, including:

(1) Skin prick/spot test: Identify specific drug ingredients;

(2) Serum test: A few drugs can draw blood to detect specific antibodies;

(3) Drug-induced experiment: Under strict monitoring and emergency preparation, give a small amount of drug, incrementally in batches to confirm whether it is allergic;

(4) Drug desensitization treatment: When necessary, certain allergic drugs can be considered for desensitization treatment under strict supervision of the ward when necessary.

(5) Preventive medication: If the patient does not have alternative drugs and cannot undergo desensitization treatment, antihistamines and glucocorticoids can be used in advance, and combined with monoclonal antibodies for prevention and protection. Because the clinical risk is high, it is necessary to strictly follow the doctor's instructions.

"These testing methods not only help patients clarify the diagnosis, but also seek valuable opportunities for surgery, treatment, etc."

Don't let "allergies" become a label for your life, recording is the first step

"The thing I want to tell you the most is: record what medicine I am allergic to and the symptoms at that time." Wang Zixi emphasized that this is not only to protect himself, but also to provide a basis for decision-making for doctors to avoid the same risks in the future.

"Allness itself does not need to panic, but once it occurs, it must be taken seriously. Only by scientifically recording, standardizing medical treatment, and rational management can we truly use medicine calmly and treat the disease with peace of mind."

[Editor in charge: Wang Yuqi]