DRUGS AS ALLERGENS: ANAPHYLAXIS
Drugs may be absorbed by mouth, by injection, by inhalation, or by contact. They may be well accepted, or they may cause intolerance or allergy. Intolerance is an exaggerated response to a large quantity of a drug, while allergy is sensitivity to the drug regardless of the quantity used.
Allergy to a drug assumes one of these forms:
a. A local inflammation and itching (for example, at the site of a penicillin injection)
b. A fixed reaction caused by swelling and itching which appears in the same place each time the drug is used ñ Hives
d. Anaphylaxis
e. Serum sickness
Drug allergy is usually less severe in children than in adults; drugs sensitize when first used, but open the door to dangerous reactions later on. A good example of this is anaphylaxis caused by a second injection of penicillin.
This is a dangerous allergic reaction which may occur after an allergy injection, a bee sting, the eating of allergenic foods, an injection of horse serum, or an injection of penicillin. The symptoms may be shock, hives, congestion in the nose, or asthma. To prevent anaphylaxis, a careful history (to avoid a potential allergen) should be taken by the child’s allergist.
A child who has had a slight reaction to penicillin should avoid its use. In case it is imperative to use it, it is much safer to have it taken by mouth than by injection. Furthermore, injections of penicillin are to be given in the arm and not in the buttocks, so that a tourniquet may be placed above the place of the injection to slow down the passing of the injected material into the circulation (in case of a reaction).
The treatment of anaphylaxis consists of:
a. An injection of adrenalin to relax the spasm of the bronchi and to diminish the secretions of the mucus glands
b. An intravenous injection of calcium gluconate
ñ Monitoring of the blood pressure so that another injection of adrenalin can be given if it becomes necessary
d. Hospitalization
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