Adverse Reactions to Drugs and Drug Allergy: Scope of This Book
In what is essentially a pharmacologically based classification of adverse drug reactions (ADRs), unpredictable and dose-independent drug reactions, designated type B reactions, include hypersensitivity responses while those reactions designated as type A are predictable, dose-dependent, and make up about 80 % of all ADRs. Previous exposure is not always a prerequisite for allergic sensitization, and there are many instances where reactions occur after initial contact with poorly reactive drugs that do not bind to proteins. Risk factors for drug allergy can be divided into those that are patient-related (age, sex, current diseases, previous exposure, genetic factors) and those that are drug-related (nature and cross-reactivity of drug, degree of exposure, route of administration). Genomic studies are already helping to explain some ADRs, for example, the association in Han Chinese of carbamazepine-induced Stevens–Johnson syndrome with HLA-B*15:02 and the association of abacavir hypersensitivity in abacavir hypersensitivity syndrome with HLA-B*57:01. It seems likely that multiple rather than single genes are involved in ADRs. Drug allergy studies promise to provide significant insights into important areas of biomedical investigation including cell recognition and interaction processes, relationships between receptors and effector pathways and mechanisms of mediator actions.
KeywordsAdverse Drug Reaction Human Leukocyte Antigen Drug Allergy World Allergy Organization Johnson Syndrome
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