Let’s go for your healthcare espresso shot!
🔸Vol.2: Allergies and the fine print…
🌳🥗💊👫🧑⚕️ Allergies—whether seasonal, food-related, or medication-related—are more or less familiar to everyone. Their symptoms and management are also quite well-known to the general public, always of course under medical guidance. However, there are misconceptions and complex cases that are good to keep in mind.
⚠️👀🗣🌍 To begin with, the possible adverse effects (side effects) of a medication are many, and the majority of them do not have an allergic basis. This is important, because an allergic reaction to a drug usually means future avoidance of it, whereas some other adverse effects may be prevented by adjusting administration instructions or by prophylactic co-administration of a second medication. A classic example is gastrointestinal side effects of antibiotics.
➡️📖💬 But let’s return to our main topic, which is allergies. Each pill contains dozens of different substances. Any one of these can trigger an allergic reaction by activating the immune system. This biological process is not always the same. For example, the substance may bind to proteins in the body and the resulting complex may activate the immune system, or it may bind directly to receptors on lymphocytes. There are also the so-called pseudo-allergic reactions, in which a pharmaceutical substance binds directly to proteins of immune cells that are not lymphocytes.
😤🥱😵💫😮💨🫣📚 Without tiring you further with such details, or analyzing interesting concepts such as atopic predisposition, repeated exposure to a drug, and multiple-drug allergy syndrome, let’s discuss an interesting example and conclude with what I would like to be the main takeaway.
⁉️💊🧪🤯 A person has received antibiotic A many times in the past, as well as anti-inflammatory drug B, without ever showing an allergic reaction. For the first time, they receive them simultaneously and end up developing an allergy. What is happening here?
📋🔎💡✅ One possible explanation in this case is that anti-inflammatory drug B has acted as a co-factor, enabling antibiotic A to trigger an allergic reaction. This means that, for antibiotic A to cause an allergy, the presence of drug B is necessary. Non-steroidal anti-inflammatory drugs are among the most common medications that act as co-factors. Another characteristic example is exercise/physical activity, which can act as a co-factor in triggering food allergies. Interestingly, after such an episode, the person may be able to take antibiotic A or anti-inflammatory drug B alone in the future without developing an allergic reaction.
🏆🎯🎗🔑 The key to recognize the fine print behind an allergy is a thorough medical history, while proper guidance for future actions after an allergic reaction depends on the severity of the reaction and unquestionably requires training and experience on the part of the physician.
📑 References
-Pichler WJ. Immune pathomechanism and classification of drug hypersensitivity. Allergy. 2019 Aug;74(8):1457-1471. doi: 10.1111/all.13765. Epub 2019 Apr 29. PMID: 30843233.
-Abrams EM, Protudjer JLP. Factoring in cofactors in the diagnosis and management of anaphylaxis. Ann Allergy Asthma Immunol. 2023 Jun;130(6):695-696. doi: 10.1016/j.anai.2023.04.009. PMID: 37270227.
-Muñoz-Cano R, Pascal M, Araujo G, Goikoetxea MJ, Valero AL, Picado C, Bartra J. Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis. Front Immunol. 2017 Sep 26;8:1193. doi: 10.3389/fimmu.2017.01193. PMID: 29018449; PMCID: PMC5623009.