Medicament Allergies - part 2

Photosensitivity

Some medications cause photosensitivity reactions, especially when the medication remains in the skin and has an adverse reaction when we are exposed to light. Usually, photosensitivity occurs when one is exposed to sunlight, but it may also occur when there is artificial light. Diagnosing photosensitivity is not very difficult as the affected area is only restricted to the skin that comes in contact with light.

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Allergic reactions due to exposure to light (also called photo-allergic reactions) have a resemblance to another condition known as contact dermatitis. This condition may occur even several months after the medication is discontinued, especially when the patient comes in contact with very bright light again. There are several medications that may cause photosensitivity and the most common among them are salicylamides (drugs used in acne medications and medicated soaps) and sulfa medications.

In addition, phototoxic reactions, which are different from allergic reactions, may be a result of using coal tar derivates as well as many other substances, such as antibiotics ciprofloxacin and doxycycline. When a person endures phototoxic reactions, he/ she may suffer from a rash that is somewhat worsened form of sunburn occurring with blisters.

Serum sickness

In most cases, penicillin is responsible for serum sickness (a common allergy to foreign serum or drug). However, it can also occur as a result of using several other drugs, such as sulfa medications, cephalosporins, and different other antibiotics, propylthiouracil (a drug used for treating hyperthyroid conditions) as well as phenytoin (an anti-epilepsy medication). Serum sickness derives its name from the fact that the condition was originally related to vaccines prepared from animal serums.

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Usually, when an individual experiences serum sickness after being exposed to a particular medication for the first time, it occurs anything between one and three weeks after starting treatment with the particular medication. The reaction may be accelerated in some days provided the individual has used the medication on earlier occasions also. The symptoms related to serum sickness include headache, fever, swelling, itching (due to a rash or hives), exhaustion, nausea, swollen lymph glands, diarrhea and swelling as well as pain in the joints.

Depending on the severity of the condition, the above mentioned symptoms may be mild or serious and also remain for many days to many weeks. Generally, the patient recuperates completely. However, in rare instances it may cause lasting neurological damage or even harm the internal organs, such as the heart, liver, pancreas, kidneys, and the adrenal glands. Serum sickness is treated by discontinuing the medication responsible for the condition and by taking oral cortisone and antihistamines. The use of these medications depends on the seriousness of the symptoms.

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Medicament fever

The fact is that sensitive people may suffer from fever after taking most medications. For instance, use of specific anti-cancer drugs usually causes fever. In addition, administering a drug through injections may also result in local inflammation, especially in the spot where the shot was administered. In such cases, inflammation may lead to fever. However, the fact remains that in a number of instances, allergic reactions are accompanied with fever. Sometimes, fevers that are associated with allergy can confuse both the patient as well as the physician, particularly when the patient is being given an antibiotic to cure an infection responsible for the fever. However, it becomes easier to diagnose the problem when the patient also experiences symptoms related to allergy, for instance, a rash. However, on many occasions such signs are not evident. Therefore, it is important for a physician to try and detect if the patient has endured medication allergy in the past. This will make diagnosis easier. In addition, the patient may also discontinue the medications he/ she is already taking and the patient's elevated body temperature will drop quickly if allergy is the root cause of the problem.

Medicines which are most commonly associated with medicament fever include penicillin, sulfa drugs, cephalosporins, specific drugs employed to treat hypertension or high blood pressure (usually methyldopa) and medications used to cure irregular heart rhythms, such as procainamide and quinidine.

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Irrespective of the nature or cause of fever, you should essentially seek medical help to cure it, because fevers may result in more grave conditions, counting acute rashes, hepatitis (inflammation of the liver) and vasculitis (blood vessel inflammation).

Medicament-induced lupus

Systemic lupus erythematosus, commonly known as lupus, is a health condition wherein the body produces antibodies that work against the tissues of the body. These antibodies, known as auto-antibodies, may cause serious damage to the blood vessels, liver, kidneys, and the heart. Such effects can also be produced by specific medications - produce antibodies that work against the tissues. A person suffering from lupus may actually not have any underlying ailment.

Medications that are most commonly associated with lupus include isoniazid (an anti-tuberculosis drug), procainamide (a medication used for treating abnormal heart rhythms), hydralazine (a drug used to treat hypertension or high blood pressure). In addition, there are some other drugs that are sometimes responsible for lupus, for instance, phenytoin (medication of epilepsy), methyldopa (medication used for treating high blood pressure) and even a number of oral contraceptives.

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When an individual suffers from lupus due to using specific medication, he/ she may experience symptoms like fevers, rashes and joint pains. In fact, these symptoms may occur even several months or even many years after they have actually begun taking or using those medications. Generally, these symptoms disappear soon once the patients discontinue the medications that are responsible for the condition. However, the antibodies produced by these offending medications remain inside the patient's body for several years.

Vasculitis

Irritation and swelling of the blood vessels, a condition medically termed as vasculitis, occur owing to use of specific medications that are generally associated with rashes - involving the vessels supplying blood to the skin. However, usually vasculitis is manifested by appearance of black-and-blue blotches, particularly on the legs. Nevertheless, this condition may also involve other body parts, such as the joints and kidneys.

Medications that are most often responsible for allergic vasculitis include penicillin, allopurinol (used to treat gout) and sulfa drugs (used for curing seizures). In addition, there is a rare type of allergic vasculitis, which may sometimes be associated with medications like Accolate and Singulaire, which are frequently used to treat asthma.

Respiratory manifestations

Use of specific medications may worsen your asthma, particularly medicines like aspirin and beta blockers. In fact, when beta blockers are used externally, like in the form of eye drops to treat glaucoma, it exacerbates asthma.

It may be noted that approximately one out of every 10 people suffering from asthma is sensitive to ibuprofen (Nuprin, Motrin), aspirin, indomethacin, as well as associated non-steroidal anti-inflammatory medications. Instead of using these medications, you may opt for Trilisate. Even acetaminophen (Tylenol) generally does not create any problem for asthma patients. However, in rare instances, people suffering from asthma and have nasal polyps taking aspirin or any other non-steroidal anti-inflammatory drugs (NSAIDs) may possible undergo an asthma attack that may prove to be life-threatening. While this kind of sensitivity is not a genuine allergy, but it can definitely make asthma worse. It is somewhat tricky to diagnose this kind of sensitivity to medications, as it cannot be detected even when a skin test is undertaken. It is important for people who are susceptible to sulfites or the yellow dye called tartrazine (FD&C #5) they should thoroughly read the product labels on medications available over-the-counter before using them and also ask their pharmacist regarding the prescription medications.

What is worse is that sometimes medicament reactions may even affect the lungs adversely. The medications that are most commonly responsible for this problem include sulfa drugs, penicillin and, on rare occasions, cromolyn - a medication that is used to put off development of symptoms related to asthma. In a number of cases involving the lungs, the sufferers may develop cough about seven to ten days after commencing treatment with specific medications. When a chest X-ray is taken, it depicts a picture similar to that of pneumonia. When a blood count test is undertaken, it shows an augmented number of a form of white blood cells called eosinophils, which are frequently found to be associated with allergic reactions.

An antibiotic known as nitrofurantoin is used for treating infections of the bladder. This medication should be used cautiously, as it generally results in a number of adverse effects, such as chills, fever, and coughing as well as even chest pain. However, all patients using the medication do not experience these symptoms. Only one out of 500 patients who use nitrofurantoin suffers these symptoms, which generally fade away a couple of days after the medication is discontinued.

Another drug, methotrexate, which is used for treating some forms of cancer, may also result in comparable problems. In addition to cancer, methotrexate is also employed for treating a number of arthritis forms. In recent times, physicians have also used this medication in the form of a steroid-sparing drug (in other words, to reduce the requirement for steroids) for people with severe asthma. All medications that are known as angiotensin-converting enzyme inhibitors (for instance, captopril) result in a common side effect - coughing. These medications are used for treating hypertension (high blood pressure). However, the problem subsides once the medication is discontinued.

Blood, liver, and kidney reactions

Often, toxic or allergic reactions caused by certain medications may result in changes in a person's blood, for instance decreasing the platelet count and also augment the chances of abnormal bleeding. In addition, it may also lead to anemia (decreased red blood cell count) and also reduce the white blood cell numbers in the blood. Even though a person may be enduring this condition, the problem is detected only when he/ she undergoes a blood test for blood count. The blood count may be undertaken when a person feels sick or as a routine matter.

As our liver metabolizes all medications we take, even this vital organ may be affected by harmful reactions caused by some medications. However, instances of liver damage may either be non-existent or restrained. Some of the more obvious symptoms of this condition may include jaundice (the skin turning yellowish), nausea or stomach ache. However, a blood examination can be undertaken to test whether the liver is in good health and functioning effectively. Medications that are most commonly associated with liver damage may include specific antidepressants, isoniazid (medication used for treating tuberculosis) as well as birth control pills, drugs used to lift moods and even a number of antibiotics.

Even the kidneys, whose main function is to help the body to get rid of toxic and waste substances, in addition to excessive water and salt, may also be negatively influenced by medications in the bloodstream. Medications that have the potential to affect the kidneys adversely include sulfa drugs, penicillin and associated cephalosporins, non-steroidal anti-inflammatory drugs, hydantoin drugs (used to treat seizures) and water pills (diuretics).

Penicillin

People in age group of 20-49 years are most susceptible to adverse effects of penicillin. In fact, the risk of severe reaction of using penicillin is more for people who are sicker. Adverse effects of penicillin may occur to any one, irrespective of their gender and ethnic background. All are susceptible to allergic reactions following penicillin use.

In fact, as people continue using penicillin, they mature out of allergies caused by the medication. If a person has suffered just a rash after using penicillin, particularly a delayed rash, it is likely that he/ she will use penicillin again when necessary, provided their skin test to using penicillin has been negative. However, people, whose skin test for penicillin was positive, will never be able to use this medication even if they have hives and any other symptoms related to anaphylactic reaction. In future, they should only undergo penicillin sensitivity tests in a hospital or allergist's offices that are adequately equipped. While desensitization may be tried in serious cases, it is all the more tricky.

Penicillin is not administered in injection form only, but some forms of this medication, such as ampicillin and amoxicillin, are also taken orally. However, in nearly all cases penicillin variants, those which are taken orally, result in allergic reactions in people who are susceptible to this medication. The symptoms of the reactions may, however, be delayed by several days or weeks.

Chemically, cephalosporins are closely related to penicillin and, hence, they also enclose allergic factors that are same as those contained in penicillin molecule. However, compared to penicillin, cephalosporins are generally less strong allergenic. Various brands of oral cephalosporins are available, including Ceftin, Ceclor, Suprax, Keflex and Velosef.

It has been found that individuals who are really allergic to penicillin are faced with anything between 5% and 16% risks of developing reactions to cephalosporins. Usually, if the use of penicillin results in a delayed and mild reaction, for instance, a rash, from the medical point of view, it will be feasible to try curing a patient using a cephalosporin when he/ she requires this medication and no effective substitute is available. The best way to treat a patient with cephalosporin is to administer the first dose of the medication in the physician's office itself in small amounts at a time and over a number of hours. If the patient develops any adverse reaction, the physician will be at hand to look into the case.

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