ALLERGIC DRUG-REACTIONS - HOW TO MINIMIZE THE RISKS

Assessment of patients in whom an allergic drug reaction is suspected should include a carefully taken drug history. This should be followed by diagnostic testing if it is available for the drug in question. If neither an alternative therapeutic agent nor a diagnostic test is ava ilable, then a provocation challenge or desensitization may be necessa ry. Increased understanding of allergic drug reactions requires the fo llowing: better pharmacoepidemiologic studies, improved in vitro and i n vivo methods of studying the immune responses involved, and expanded comparisons between the pharmacokinetics and pharmacodynamic effects of drugs and their metabolites. Until improvements are made in these a reas, the appropriate approach is to avoid the unnecessary use of drug s. When a drug is required, patient risk factors for an allergic react ion must always be weighed against the benefits of treatment.