engleski

Nonallergic hypersensitivity to nonsteroidal antiinflamatory drugs, angiotensin-converting enzyme inhibitors, radicontrast media, local anesthetics, volume substitutes and medications used in general anesthesia

Urticaria and angioedema are common allergic manifestation and affect between 1 to 25% of the population. Medications are one of common triggering factors that may cause urticaria and/or angioedema. The most severe immediate drug reaction is anaphylaxis. Apart from the well established IgE-mediated immediate type hypersensitivity reactions, the pathogenesis of drug-induced urticaria, angioedema and anaphylaxis is often not clear. Main emphasis in this article is on pseudoallergic and idiosyncratic reactions to the most common drug groups, the nonsteroidal antiinflammatory drugs (NSAIDs, cyclo-oxygenase inhibitors), the angiotensin-converting-enzyme (ACE) inhibitors, radiocontrast media and plasma expanders. Urticaria is a classic cutaneous manifestation of drug allergy and is considered to be the second most common drug eruption after maculopapular exanthema . The mechanism of acute urticarial reactions are multiple, mostly are IgE mediated, but some drugs can induce immune complexe reactions and activate complement cascade, while others can induce direct activation of mast cells and degranulation or activate complement by non immunological mechanisms. ACE inhibitors are widely used drugs in cardial and renal patients, but life treathening angioedema may occur as a result of use of this group of medications. As a very important diagnostic tool, radiocontrast media are very frequently used, and rarely severe important immediate hypersensivity reactions can occur. Most of these reactions are not true allergy. Amoung the numerous medication which can elicitate these reactions, also plasma expanders have the potential of causing this kind of reactions.

pseudoallergy ; non-allergic hypersensivity ; drug intolerance ; drug hypersensivity ; anaphylactoid reaction ; allergy-like reactions

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