Drug Hypersensitivity

Approaches the phenomenon of drug hypersensitivity in a comprehensive manner. Besides epidemiological aspects, it addresses the immunological mechanisms underlying these complicated reactions which go far beyond the IgE-mediated drug allergies also considered in this book. The book also covers clinical manifestations and new diagnostic methods, and introduces some recetly established animal models. Many topics are treated from multiple perspectives, and the 33 chapters are thoroughly cross-referenced.

With a focus on improving diagnosis and treatment, Drug Allergy Testing is your new go-to resource for understanding various drug allergies and testing methods, the epidemiology of and economic impact of drug allergies, and new drug and allergy developments. Features a wealth of up-to-date information for allergists, immunologists, and primary care physicians who diagnose and treat patients with drug allergies and hypersensitivity. Covers the basics of drug allergy evaluation and management as well as specific drugs including antibiotics, ASA/NSAIDs, chemotherapeutic agents and monoclonal antibodies.

This issue of Immunology and Allergy Clinics, guest edited by Mariana Castells, is devoted to Drug Hypersensitivity and Desensitizations. Articles in this issue include: Principles and Practice of Drug Desensitization; Incidence and Prevalence of Drug Hypersensitivity; Drug-Induced Anaphylaxis; Penicillin and Beta Lactam Hypersensitivity; Platins Chemotherapy Hypersensitivity: Prevalence and Management; Monoclonal Antibodies Hypersensitivity: Prevalence and Management; Injectable Drugs and MoAbs Reactions and Management with Desensitization; Delayed Cutaneous Reactions to Antibiotics, Management with Desensitization; Management of Children with Hypersensitivity to Antibiotics and MoAbs; Taxenes Hypersensitivity and Management; Progesterone Autoimmune Dermatitis; Severe Delayed Drug Reaction: Role of Genetics and Viral Infections; andAspirin and NSAIDS Hypersensitivity and Management.

The variety of chemically diverse pharmacological agents administered to patients is large and continues to expand and with every new drug released, there is always potential for adverse reactions, some of them allergic. With its roots in immunology and pharmacology, the science of drug allergy is becoming better understood and applied as its importance is increasingly recognized throughout the many branches of medicine. Drug Allergy: Clinical Aspects, Diagnosis, Mechanisms, Structure-Activity Relationships sheds new light on this field. Comprehensive in design, this authoritative title identifies the most important culprit drugs implicated in immediate and delayed drug hypersensitivities and offers up-to-date information on classifications, diagnoses, underlying mechanisms and structure-activity relationships. Chapters dealing with the molecular and cellular mechanisms of drug hypersensitivities, non-immune-mediated sensitivities and diagnostic methods are presented as introductory material for in-depth treatises on the β-lactam antibiotics, other antibiotics and antimicrobials, drugs used in anesthesia and surgery, opioid analgesics, corticosteroids, monoclonal antibodies and other biologics, drugs used in chemotherapy, proton pump inhibitors, iodinated and gadolinium-based contrast media and non-steroidal anti-inflammatory drugs. In addition to being of immense value to clinicians, other health care professionals and researchers, this title will prove invaluable for those taking undergraduate and graduate courses in science and will also serve as a useful text for students of medicine, pharmacy, nursing and dentistry.

This issue of Immunology and Allergy Clinics, edited by Dr. Pascal Demoly, is devoted to Drug Hypersensitivity. Articles in this issue include: Drug allergy diagnosis; Principles of drug allergy management: acute drug reactions, individual preventive measures, desensitization, general preventive measures; Antibiotics allergy; Non-steroidal anti-inflammatory drugs HS; Local and general anesthetics allergy; Radiocontrast media and dyes allergy; Chemotherapeutic agents allergy; Vaccine allergy; Biological agents HS; Anti-epileptic allergy; Iron and Vitamin Allergy; Antiviral drug allergy; Additive allergy; and Unmet needs in drug allergy.

This book covers all aspects of hypersensitivity to drugs, providing practical information for non-specialist physicians as well as addressing issues of interest to practitioners in different specialties and presenting the expert knowledge required by specialist allergists and immunologists. The opening, general section discusses basics such as clinical manifestations, histopathology, mechanisms, risk factors, drug hypersensitivity in particular populations, and the full range of diagnostic methods. The second part of the book provides concise information on the most important drug classes and guides the reader on how to proceed when patients present with a suspected reaction. For each drug class, the current level of evidence for use of the different diagnostic tools, including skin tests, provocation tests, and in vitro tests, is clarified, and management options, outlined. The inclusion of helpful tables and algorithms is designed to aid in decision making. Drug hypersensitivity is among the more complex allergological issues, and this book will meet the needs of general practitioners, internists, and specialists.

Pediatric Allergy supplies the comprehensive guidance you need to diagnose, manage, and treat virtually any type of allergy seen in children. Drs. Leung, Sampson, Geha, and Szefler present the new full-color second edition, with coverage of the diagnosis and management of anaphylaxis, the immune mechanisms underlying allergic disease, the latest diagnostic tests, and more. Treat the full range of pediatric allergic and immunologic diseases through clinically focused coverage relevant to both allergists and pediatricians. Understand the care and treatment of pediatric patients thanks to clinical pearls discussing the best approaches. Easily refer to appendices that list common food allergies and autoantibodies in autoimmune diseases. Apply the newest diagnostic tests available—for asthma, upper respiratory allergy, and more—and know their benefits and contraindications. Treat the allergy at its source rather than the resulting reactions through an understanding of the immune mechanisms underlying allergic diseases. Get coverage of new research that affects methods of patient treatment and discusses potential reasons for increased allergies in some individuals. Better manage potential anaphylaxis cases through analysis of contributing facts and progression of allergic disease. Effectively control asthma and monitor its progression using the new step-by-step approach. Eliminate difficulty in prescribing antibiotics thanks to coverage of drug allergies and cross-reactivity.

Biomarkers, especially those based on pharmacogenomics testing, have proved to be extremely useful for type A adverse drug reactions. Clinical practice guidelines based on biomarker testing are presently being developed and updated for type A adverse drug reactions. In contrast, little attention has been paid to the potential use of biomarkers in type B adverse reactions, characterized by the occurrence of reactions not directly related to the pharmacological properties of the drug. Drug-induced hypersensitivity belongs to those type B reactions. Drug-induced hypersensitivity reactions involve complex mechanisms that include, among others, the metabolic activation and haptenization of drug metabolites. Hence, factors that influence the pharmacokinetics of drug and metabolites may contribute to the development of some drug-induced hypersensitivity reactions. This implies that processes such as ADME (absorption, distribution, metabolism and excretion) that are typically involved in type A adverse drug reactions, may have a role in hypersensitivity reactions too. In addition to metabolic activation, several signal transduction pathways participate and modulate the development and the clinical presentation of drug hypersensitivity. The diverse mechanisms underlying such drug-hypersensitivity reactions lead to four major groups of reactions according to the Gell and Coombs classification: immediate, cytotoxic, immune complex and delayed. The enormous complexity of drug-hypersensitivity reactions is a consequence of the variety of mechanisms involved, which may be related, among others, to drug metabolism, generation of antigenic signals, stimulation and maturation of dendritic cells, presentation of haptens and mechanisms of cytotoxicity. In addition, a plethora of possible clinical presentations exists, including urticaria, angioedema, anaphylaxis, cytopenias, nephritis, serum sickness, vasculitis, contact dermatitis, drug rash, eosinophilia and systemic symptoms, Stevens–Johnson syndrome, toxic epidermal necrolysis and acute generalized exanthematous pustulosis. The rapid progress in the field in recent years indicates that the combination of several disciplines is essential to understand the mechanisms involved in this particular, and not completely understood, type of adverse drug reactions. The objective of this Research Topic is to present insights obtained from both basic and clinical scientists, which may include studies related to the identification, validation, refinement and clinical implementation of biomarkers for drug-induced hypersensitivity. The Topic aims to include recent findings related, but not limited to, potential phenomic, genomic, proteomic, metabolomic and signal transduction biomarkers. These biomarkers could eventually be used in clinical practice and/or these might contribute, as a proof of concept, to our understanding of the complex events leading to drug hypersensitivity reactions. In addition the Topic will cover recent developments and methodological advances in the diagnosis, prevention and therapeutic management of drug-induced hypersensitivity.