TY  - CHAP
M1  - Book, Section
TI  - Drug Allergy
A1  - Sylvia, Lynne M.
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
Y1  - 2017
N1  - 
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Patient  Care  Process  for  the  Management  of  Drug  AllergyCollectPatient  characteristics  (e.g.,  age,  race,  sex,  pregnant)Medication  history  (e.g.,  prescription,  OTC,  and  complementary  medications  such  as  herbals)  Allergy  history  (e.g.,  medications,  foods,  environmental  exposures  with  descriptions  of  each  reaction)  Subjective  findings  of  the  allergic  reaction  (e.g.,  shortness  of  breath,  itching,  feeling  of  flushing,  lip  tingling,  nausea,  lightheadedness)  Objective  dataBP,  HR,  RRLabs  (e.g.,  serum  electrolytes,  Scr,  BUN,  LFTs)Observation  of  the  rash,  if  applicable  (e.g.,  type  of  lesion(s),  distribution  of  lesions,  presence  or  absence  of  oral  or  genital  ulcerations,  presence  or  absence  of  bullae)AssessTiming  of  the  reaction  relative  to  the  initiation  of  each  of  the  patient's  current  medications  Likelihood  of  cross-reactivity  relative  to  documented  allergy  history  (e.g.,  previous  documented  allergy  to  penicillin  in  a  patient  currently  receiving  a  beta-lactam  antibiotic)  Presence  of  risk  factors  (see  section  on  Factors  related  to  the  Risk  or  Severity  of  Allergic  Drug  Reactions)  Co-administration  of  medications  that  may  increase  the  risk  of  an  allergic  reaction  when  used  in  combination  (e.g.,  lamotrigine  and  valproate)Severity  of  the  reaction  (e.g.,  localized  rash  versus  a  systemic  reaction  involving  one  or  more  organs)  Medications  that  may  interfere  with  the  identification  or  treatment  of  the  allergic  reaction  (e.g.,  chronic  use  of  antihistamines  when  skin  testing  may  be  warranted;  chronic  beta-blocker  use  in  a  patient  with  anaphylaxis)  Need  for  drug  desensitization  or  induction  of  drug  tolerance  (see  Tabe  e-88-5)  Plan*Management  of  the  allergic  reaction  (see  Table  e-88-3  if  patient  presents  with  anaphylaxis)  Management  of  the  condition  for  which  the  allergic  medication  was  indicated  (e.g.,  treatment  of  the  underlying  infection  for  which  the  allergenic  antibiotic  was  indicated)  Patient  education  (e.g.,  recognition  of  likely  allergenic  medication,  risk  of  cross-reactivity  with  related  agents,  use  of  epinephrine  self-injectors  if  applicable)Referals  to  other  providers  when  appropriate  (e.g.,  allergist)Implement*Provide  education  to  health  care  providers  on  an  effective  management  plan  of  allergic  reactionDrug  desensitization  or  graded  challenge  protocols,  if  appropriateDrug  skin  testing,  if  appropriateFollow-up:  Monitor  and  EvaluateAssess  responsiveness  to  the  management  plan  and  revise  the  plan,  if  applicable  Identify  causative  medication  based  on  responsiveness  to  drug  discontinuation  and  treatment  Document  allergic  reaction  and  update  drug  allergy  information  in  medical  recordReinforce  patient  education  on  allergic  medication,  type  of  reaction,  potential  cross-reactive  medication  and  self-management  of  reaction  (if  applicable)*Collaborate  with  patient,  caregivers,  and  other  health  professionals  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1148582521
ER  -