Ja. Bernstein, NONIMMUNOLOGICAL ADVERSE DRUG-REACTIONS - HOW TO RECOGNIZE AND CATEGORIZE SOME COMMON REACTIONS, Postgraduate medicine, 98(1), 1995, pp. 120
When a patient experiences an adverse drug reaction, the history is in
most instances the only clinical tool available for establishing a di
agnosis. Thus, when taking a history, physicians should always inquire
about drugs the patient has been taking and prior reactions to drugs,
Clinicians should characterize every adverse drug reaction according
to an accepted classification system. Familiarity with the types of re
actions discussed here is therefore essential. The majority of adverse
drug reactions are nonimmunologic in origin, and the most common reac
tions occur in response to relatively few classes of drugs, It is impo
rtant not to incorrectly label a reaction as allergic, since this impl
ies an immune-mediated response, which often precludes future use of t
he drug, On the other hand, if there is any concern that a reaction ma
y be allergic, it is best to err on the side of caution by using an al
ternative, non-cross-reacting drug for treatment.