Medication Allergy & Desensitization
Non-steroidal Anti-inflammatory drugs (NSAIDS)
Despite their widespread use and over-the-counter availability, NSAIDS such as aspirin, ibuprofen or naproxen can often cause serious allergic reactions. If an injury occurs or if a condition arises that necessitates these medications, those with allergies often struggle to find alternatives.
Reactions to NSAIDs can occur due to a number of mechanisms. In some cases, the body creates antibodies (IgE) against the medication triggering allergic responses. The antibodies attach to the drug the next time it is consumed, causing the immune system to trigger an allergic reaction. There are also non-allergic responses that can flare up from NSAID consumption. This occurs when the medication blocks the body’s COX-1 enzyme. Allergic reactions range from mild to severe and often include hives or itchy skin, coughing or wheezing, and angioedema (swelling of the skin).
For patients with asthma, nasal polyps, or other respiratory conditions, aspirin or other NSAIDS may cause severe symptoms involving the nose, eyes and lungs. . These types of reactions are known as Samter’s Triad or Aspirin Exacerbated Respiratory Disease (AERD). AERD can cause serious health problems, such as chronic asthmatic episodes or the need for recurrent sinus surgeries for polyp removal.
Penicillin Allergy
Allergy to penicillin is very commonly documented in patient charts but is much less common than commonly thought. About 10% of the population is reported to have penicillin allergy, but more than 90% of such patients are found not to be allergic. Appropriate evaluation of patients with a history of penicillin allergy is done aby taking a careful history regarding reactions in addition to skin testing.
Many drug reactions are immediate (type I IgE-mediated reactions) triggering symptoms within the first hour after dosing but can take up to two hours particularly if medication was taken by mouth and with food. Symptoms can include hives, itching, swelling, wheezing, shortness of breath, low blood pressure, and loss of consciousness.
Allergy Partners offers comprehensive testing to identify allergies to medications. The first step of this process is a detailed evaluation of your medical history, including any reactions experienced after taking medications in the past. This may be followed by skin-prick tests to determine if there are allergies to specific medications or active ingredients within them. Blood tests are also commonly used to measure your sensitivity and reaction time to suspected drugs.
In the case of penicillin, the frequency of positive test results indicating an allergy often decreases over time. Many patients often lose their allergic sensitivity to penicillin over the course of their life. That’s why accurate testing is critical to understanding your allergy and when communicating to health care professionals prior to procedures and treatments.
Four Steps to Relief
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Planning Your First Visit
Schedule an appointment at your local office and fill out our pre-registration and medical history forms to help minimize any wait time when you arrive.
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Your First Visit
Your initial visit will last between two and three hours and consist of an initial consultation, evaluation, and comprehensive exam. We’ll create a treatment plan tailored to your unique needs.
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Diagnostics and Testing
We may complete one or more tests to better understand the cause of your symptoms. Common tests include skin testing, pulmonary testing, and blood testing.
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Treatment
Following the evaluation and testing, we’ll provide a comprehensive diagnosis and implement a personalized treatment plan that will deliver relief.
Treatment
For patients who are sensitive to NSAIDs and penicillin, avoidance has always been the cornerstone of treatment. However, a well-researched and successful alternative is medication desensitization, which your Allergy Partners allergist may recommend for you depending on your condition and health needs.
What Medication Desensitization Looks Like
Desensitization is the process of gradually and carefully administering an allergen to an allergic person. Initially, the dose is quite small and then gradually increased over time. Once the final target dose is reached, the person continues to take that dose daily. Desensitization procedures are conducted at our office under close medical supervision.
If desensitization is recommended for you, you can expect the following:
- An initial consultation with a physician to determine if desensitization is indeed an appropriate treatment.
- A thorough explanation of the procedure and associated risks.
- Lung function testing to ensure breathing is stable and airways are clear before beginning the procedure.
- Premedication with medications such as antihistamines, oral steroids, and leukotriene modifiers to decrease the risk of reactions.
- Follow-up visits with your physician to monitor ongoing desensitization.
The Allergy Partners Difference
Our physicians at Allergy Partners are educated and experienced in the diagnosis, management, and treatment of allergic illnesses, including medication allergies and desensitization. Your Allergy Partners allergist will analyze your medical history, conduct a physical exam, confirm or rule out a medication allergy and determine whether desensitization is suitable for you and your unique condition. Together, we will create a thorough and individualized treatment plan that will allow you to manage your allergic condition comfortably and confidently.
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