Drug allergy

약물 알레르기(Drug allergy)

분류

Immunologic drug reaction(drug allergy)

Skin test로 진단

• Anaphylaxis: Penicillin(m/c), cephalosporin, insulin
• Immune Complex: serum sickness
• Cytotoxicity & delayed hypersensitivity: SJS, TEN, Drug-induced hypersensitivity syndrome

Nonimmunologic drug reaction

유발 검사로 진단

• Pseudoallergy(anaphylactoid): opioids, radiocontrast media
• Idiosyncrasy(unknown reason): aspirin, NSAIDs, quinidine induced drug fever

진단

• 경구유발검사: asprin, NSAID, sulfite
• skin test(첩포, 피내 검사 등): penicillin, cephalosporins, insulin 등
• RAST

치료

• 원인 약제 중단(TOC)
• 대증 치료: antihistamine, steroid
• 대체 약물
  • aspirin: celecoxib, acetaminophen
  • penicillin: vancomycin, monobactam
• 탈감작: penicillin, insulin 등