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Couv Drug Allergy Phadia Suède This latest edition of Drug Allergy, indisputable reference source for drug allergies, is a response to Drug Allergy the constantly growing number of new molecules being added to the therapeutic armamentarium. It includes references to the latest publications available in the medical literature. Conceived and written by a team of French physicians led by Professor Daniel Vervloet, this book is an indispensible tool for both the medical practitioner and the medical laboratory. Drug Allergy Marie-Christine Koeppel Joëlle Birnbaum Michel Pradal Daniel Vervloet Daniel Vervloet ISBN 978-2-9520036-1-2 EAN 9782952003612 Michel Pradal Joëlle Birnbaum Marie-Christine Koeppel Phadia AB. P O Box 6460, SE-751 37 Uppsala, Sweden Tel +46 18 16 50 00. www.phadia.com Head office Sweden +46 18 16 50 00 Austria +43 1 270 20 20 Belgium +32 2 749 55 15 Brazil +55 11 3345 5050 Denmark +45 7023 3306 Finland +358 9 8520 2560 France +33 1 61 37 34 30 Germany +49 761 47 8050 Great Britain/Ireland +44 1 908 769 110 Italy +39 02 641 634 11 Japan +81 3 5365 8332 Korea +82 2 2027 5400 Netherlands +31 30 602 3700 Norway +47 21 67 32 80 Portugal +351 21 423 5350 South Africa +27 11 793 5337 Spain +34 935 765 800 Sweden +46 18 16 50 00 Switzerland +41 43 343 4050 Taiwan +886 2 2516 0925 United States +1 800 346 4364 Other +46 18 16 56 16 52-5103-59/03 DA preface 1-6 16/02/09 15:12 Page 1 Daniel VERVLOET - Michel PRADAL - Joëlle BIRNBAUM - Marie-Christine KOEPPEL Department of Pneumology and Allergy Department of Dermatology Hôpital Sainte Marguerite Hôpital Nord Université de la Méditerranée Marseille - France DRUG ALLERGY Drug Allergy • 1 DA preface 1-6 16/02/09 15:12 Page 2 Copyright Phadia AB Editorial coordination and bibliography : Dr David A. Lévy Editorial assistant : Sandrine Fidalgo Layout : Françoise Calley Printed in France by Corlet imprimeur. Editions de Condé 103 rue de Sèvres 75006 Paris www.editions-de-conde.fr 2 • Drug Allergy DA preface 1-6 16/02/09 15:12 Page 3 TABLE OF CONTENTS PREFACE ......................................................................................................... 5 INTRODUCTION ............................................................................................... 6 I• DRUGS AND SUBSTANCES USED DURING ANESTHESIA AND INTENSIVE CARE ................................................................................ 7 II• ANALGESICS AND ANTI-INFLAMMATORY DRUGS............................................ 43 III• ANTIBIOTICS AND ANTIPARASITE DRUGS, ANTIVIRAL AND ANTIFUNGAL DRUGS ........................................................ 57 IV• CHEMOTHERAPY DRUGS AND IMMUNO-SUPPRESSORS ................................. 139 V• DRUGS USED IN CARDIOLOGY AND VASCULAR DISORDERS ........................... 211 VI• DYES, PRESERVATIVES, ANTISEPTICS......................................................... 261 VII• PRODUCTS USED IN DIALYSIS .................................................................. 289 VIII• DIAGNOSTIC AGENTS .............................................................................. 295 IX• HORMONES AND ENZYMES...................................................................... 311 X• SERA AND VACCINES............................................................................... 333 XI• VITAMINS ............................................................................................. 359 XII• GASTROENTEROLOGY.............................................................................. 371 XIII• BIOLOGICAL AGENTS............................................................................... 379 XIV• DRUGS USED IN NEUROLOGY AND RHEUMATOLOGY .................................... 407 XV• MISCELLANEOUS ..................................................................................... 435 INDEX ......................................................................................................... 444 Drug Allergy • 3 DA preface 1-6 16/02/09 15:12 Page 4 4 • Drug Allergy DA preface 1-6 16/02/09 15:12 Page 5 PREFACE he first edition of this work was based on Dr. Michel Pradal’s T thesis, one of the requirements for his medical degree, which he obtained in 1987. Now, twenty years later, we have produced the forth edition of this work. Our aim, as in the previous editions, is to help doctors, especially allergists, diagnosis drug allergy - a constantly expanding field - in a practical way. For each drug known or suspected of being responsible for allergic reactions, the incidence, clinical manifestations, diagnostic methods and management are described, with a few relevant references at the end of each section. Many new drugs have appeared on the market during the last decade, biological agents for example, and they are included in this present edition. This work was achieved thanks to the participation of Doctors Michel Pradal, Joëlle Birnbaum, and Marie-Christine Koeppel. I also want to thank Dr. David A. Levy for his help with the bibliography research and for editing the manuscript. I hope that doctors will find the information in this book useful in their practice. Daniel Vervloet Drug Allergy • 5 DA preface 1-6 16/02/09 15:12 Page 6 INTRODUCTION dverse drugs reactions involve two different mechanisms: A allergic and non-allergic reactions. Misclassification is frequent, and the word “allergy” is often misused. Twenty years ago, very few sessions at international allergy meetings focused on drug allergy. However, during the past decade a tremendous amount of work has been done on this subject, including epidemiological studies, immunological research on IgE and non- IgE mechanisms, as well as the development of drug allergy and drug vigilance networks. However, it is still difficult for the clinician to manage a patient suffering from drug allergy. The incidence of these reactions, risk factors, mechanisms, clinical manifestations, diagnostic methods and management may differ from drug to drug and from patient to patient. As I mentioned 10 years ago in the Third Edition of this book “as drug allergy is concerned, there is one general rule, i.e., there are no general rules”. That is why in this book we have tried to develop for each drug specific rules to follow to arrive at a cor- rect diagnosis and then the best way to manage the patient. 6 • Drug Allergy DA Chapitre 1 11/02/09 12:33 Page 7 I DRUGS USED FOR ANESTHESIA AND INTENSIVE CARE Drug Allergy - chapter I •7 DA Chapitre 1 11/02/09 12:33 Page 8 Alfentanil, Fentanyl, Remifentanil, Sufentanil Major morphinomimetic analgesics, used in anesthesia. S Incidence Extremely rare. S Risk factors Previous sensitization to another phenylpiperidine drug. S Clinical manifestations • General The clinical manifestations of anaphylaxis are classified into five grades of severity: - Grade I: mild, self-limiting reactions, e.g., isolated skin symptoms; - Grade II: moderate reactions quickly responding to therapy, e.g., hypotension, bronchospasm or multivisceral symptoms; - Grade III: severe reactions requiring prolonged treatment, e.g., anaphylactic shock; - Grade IV: cardiac and respiratory arrest; - Grade V: death • Cutaneous: application site reactions including itching, erythema, papules and oedema; diffuse rash. S Diagnostic methods Skin tests: Concentration normally non-reactive in practice. • Alfentanil (0.5mg/ml): Prick test: undiluted (0.5mg/ml) Intradermal tests 1/10 (50µg/ml) • Fentanyl (0.05 mg/ml): Prick test: undiluted (0.05 mg/ml) Intradermal tests: 1/10 (5µg/ml) • Remifentanyl (0.05 mg/ml): Prick test: undiluted (0.05 mg/ml) Intradermal tests: 1/10 (5µg/ml) • Sufentanyl (0.005 mg/ml): Prick test: undiluted (0.005 mg/ml) Intradermal tests: 0.5µg/ml Dilution series is used starting with a 1/10,000 dilution and increasing the concentration up to the highest level that usually does not produce a reaction in non-allergic individuals. S Mechanisms These drugs apparently do not induce non-specific mediator release from mast cells. IgE-mediated hypersensitivity, as indicated by positive skin-tests is restricted to fentanyl. S Management Avoidance. 8• Drug Allergy - chapter I DA Chapitre 1 11/02/09 12:33 Page 9 No cross-reactivity between the different opioid subclasses phenanthrenes, phenylpiperidines, and diphenylheptanes. References Muijsers RB, Wagstaff AJ. Transdermal fentanyl: an updated review of its pharmacological and therapeutic effi- cacity in chronic cancer pain control. Drugs 2001;61:2289 – 2307. Bennett MJ, Anderson LK, Mc Millan JC, et al. Anaphylactic reaction during anaesthesia associated with positive intradermal skin test to fentanyl. Can Anaesth Soc. J 1986;33:75-8. Drug Allergy - chapter I •9 DA Chapitre 1 11/02/09 12:33 Page 10 Local anesthetics With their ability to block pain signals to the brain, local anesthetics (LAs) have made possi- ble many surgical procedures once thought impossible. LAs are generally safe and well tole- rated. Local anesthetics are classified as either ester or amide compounds: Q Ester LAs, all derivatives of para-aminibenzoic acid, include cocaine, procaine, tetracaine, benzocaine, and chloroprocaine. Ester LAs are associated with a higher incidence of allergic reactions. Q Amide LAs, by far the most widely used today, include lidocaine, mepivacaine, etidocaine, prilocaine, bupivacaine, and dibucaine. S Incidence 2 to 3% of local anesthesias (fainting). The true incidence of allergic reactions to LAs is unknown, but exceedingly rare, less than 1% of all anesthetic-induced reactions. The incidence of systemic toxicity has significantly decreased in the past 30 years, from 0.3 to 0.01%. S Risk
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