Adverse reactions to aspirin (ASA) and nonsteroidal anti-inflammatory
drugs (NSAIDs) have been recognized for many years. Systemic or genera
lized reactions to ASA/NSAIDs include (1) acute respiratory reactions,
characterized by nasal mucosal swelling, laryngeal spasm, and broncho
spasm; (2) initiation or perpetuation of urticaria; and (3) anaphylaxi
s (anaphylactoid reactions). Each of these systemic reactions presents
with different clinical patterns, target organ responses, and mechani
sms of action. This article focuses on the spectrum of reactions induc
ed by ASA and NSAIDs, the clinical settings in which these reactions o
ccur, as well as current insights into pathogenesis and management str
ategies that might be helpful to practicing physicians.