DRUG ALLERGY - NONSTEROIDAL ANTIINFLAMMAT ORY DRUGS AND ANALGESICS

NSAID and analgesics are widely used drugs because they belong to the so called over-the-counter-medications. According to this, side effect s of this therapy are well known and occur with an incidence of about 1%. Ln patients with asthma bronchiole the prevalence of adverse react ions may reach over 40%. Although often mimicking immediate type aller gic reactions, seldom specific IgE antibodies can be found, so that th e mechanism of these reactions commonly is pseudo-allergic. Today, onl y parts of the pathophysiology of the pseudo-allergic reactions are un derstood despite the fact that much research has been done so far. The patients history and oral provocation tests (OPT) are the key element s in the diagnosis of these types of pseudo-allergy because skin rests and in vitro procedures do not deliver reliable results. Oral provoca tion tests art criticized for their risk of causing severe side-effect s during thr procedure, the high costs, and the extensive time for pro vocation, but represent, nevertheless, the only diagnostic way in orde r to identify the susceptive medications or to find a safe alternative drug. Severe pseudo-allergic reactions may occur in these patients ev en after taking chemically not related substances, therefore, an alter native medication should only be advised after an oral provocation tes t.