Drug Allergy and Adverse Drug Reactions

  • Faoud T. IshmaelEmail author
  • Ronaldo Paolo Panganiban
  • Simin Zhang
Living reference work entry


Adverse reactions to drugs are common and may result in increased healthcare utilization and cost. It is important to distinguish between medication side effects and hypersensitivity, as recommendations regarding medication use and diagnostic testing depend on this classification. Hypersensitivity is driven by immune reactions to medications and can be categorized according to the Gell and Coombs classification, as discussed in this chapter. Hypersensitivity to antibiotics account for a majority of allergic drug reactions. However, reactions can occur to almost any drug, and allergy to anesthetics, chemotherapeutic agents, NSAIDs, biologics, and radiocontrast are important considerations. This chapter will review the mechanisms and clinical features that underlie allergy to each of these classes of medications. Furthermore, approaches to diagnosis and management of drug hypersensitivity will be discussed. The chapter will also review severe drug reactions, such as Stevens-Johnson Syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, and drug rash with eosinophils and systemic symptoms, as these are life threatening reactions that require immediate recognition.


Drug allergy Hypersensitivity Desensitization Mechanism 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Faoud T. Ishmael
    • 1
    • 2
    Email author
  • Ronaldo Paolo Panganiban
    • 2
  • Simin Zhang
    • 2
  1. 1.Division of Pulmonary and Critical Care Medicine, Section of Allergy and ImmunologyPenn State College of MedicineHersheyUSA
  2. 2.Department of MedicineThe Pennsylvania State University Milton S. Hershey Medical CenterHersheyUSA

Section editors and affiliations

  • Tim Craig
    • 1
  • Massoud Mahmoudi
    • 2
  1. 1.Penn State UniversityHersheyUSA
  2. 2.Department of MedicineUniversity of CaliforniaSan FranciscoUSA

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