Drug allergy: unpredictable danger!

At the Hospital of Tropical Diseases (BV) Cho Ray on December 8, 2006, there were six cases of drug allergies, including severe cases of Stevens - Johnson syndrome.

A patient with drug allergy (Photo: Kim Son)

Ms. TNT, 28 years old, lives in Thot Not, Can Tho, in the state of skin peeling all over and is scaling her scalp. She was eight weeks pregnant, had a fever, so she went to an obstetrician's doctor's office, who gave her a shot and gave her medicine three times a day. Shortly afterwards, she had numbness, itching, and a rash around her lips. The next day, the doctor told BS but BS told him that it was okay, still gave him a shot and gave him medicine twice a day. Back home, she had a rash more and more, had to go to district hospital. After that, she had a water balloon spread all over her body, her family asked to transfer to Cho Ray Hospital. A few days later, she had a miscarriage.

Mr. TVD, 64 years old, residing in Tan Bien, Tay Ninh, suffered a cold, went to a pharmacy to buy oral antibiotics, did not remember any drugs, had a red rash, went to the provincial Dermatology Hospital to treat without reducing, transfer Hospital Market Falling from November 20, 2006. Mr. TVD has skin peeling .

Any medication can cause a reaction

Referring to cases of drug allergies, Dr. Tran Quang Binh - Head of Tropical Diseases Hospital of Cho Ray Hospital - said the drug reaction has many forms: heavy as anaphylaxis can cause death, reaction on skin, mucosa, respiratory system, cardiovascular, causing coagulopathy . Some drugs have effects on pregnancy such as birth defects.

According to Tran Quang Binh, some sulfamid eye drops may also cause Stevens-Johnson syndrome, which may even cause anaphylaxis. In general, all drugs are likely to cause adverse reactions. At the top of the table, there must be antibiotics: severe anaphylactic reactions, mild body peeling. Some drugs such as hansen drugs (DDS), sulfate-containing diabetes medications, drugs for treating joint and nerve pain (antiepileptic drugs), some gout medications . can also cause Stevens - Johnson syndrome, Lyell.

Some drugs affecting the cardiovascular system such as Novocain, Lydocain, vitamin C, vitamin B1 injections . can cause anaphylaxis. Even aspirin drink can cause anaphylaxis. There were no medications that had been used many times before, but there was a reaction. Drugs such as streptomycin, kanamycin, gentamcin, amino glycoside drugs . long-term ingestion or injection can affect the kidneys (causing kidney failure) and nervous system number 8 (causing vestibular disorders, dizziness). .

Some drugs affect the digestive system such as steroid anti-inflammatory drugs and non-steroidal anti-inflammatory drugs that cause stomach ulcers. Some people only take one aspirin tablet to be emergency because of gastric perforation. Some medications may affect the liver causing drug-induced hepatitis, such as tuberculosis drugs. There are drugs that affect the hematopoietic organs that cause irreversible myelosuppression such as tifomycin, chloramphenicol . Even in the world medicine, it has been reported that the use of chloramphenicol eye drops also causes myelosuppression despite a very low rate - 1 VND100,000 to 1 / 1,000,000.

How do patients know they have a drug reaction?

Dr. Tran Quang Binh said that drug allergy is divided into three categories. The most immediate and severe reaction is an anaphylactic reaction, which is a common clinical manifestation of anaphylactic shock - a panic, anxiety, sweating, cold hands and feet, shortness of breath, rapid pulse, a drop in blood pressure. cardiac arrest, if the emergency is not timely, can die within a few minutes. Lighter can cause skin reactions: itching, skin rash (may be localized or spread throughout the body). Slower reactions outside the skin after a few hours to a few days such as Stevens - Johnson syndrome, Lyell syndrome - peeling, peeling of the entire body lining, patients can also die later due to skin infections and sepsis . After using the drug, if you have the above symptoms, you should go to the hospital immediately and inform BS about the medicines you have used completely.

There are many symptoms that patients cannot know such as taking drugs with vestibular disorders, kidney failure, blood cell loss .

Dr. Tran Quang Binh emphasized that folk remedies such as drinking green bean juice for medicine, drinking lemon juice, egg white . have not had a scientific basis to prove.

In short, when using the drug, it is necessary to comply with the prescription. When going to the doctor, the patient should notify the doctor of any medications that he or she has had previous allergies or reactions (if known). Should not abuse drugs and especially do not buy drugs for treatment, especially antibiotics and some specialized drugs, including eye drops containing antibiotics must also follow the instructions of the physician.

KIM SON