Piotrowicz-Wójcik Katarzyna, Porebski Grzegorz, Czarnobilska Ewa
Przegl Lek. 2013;70(12):1008-10.
Drug hypersensitivity can occur with almost any drug and may range widely in clinical severity from mild pruritus, acute urticaria or angioedema to life-threatening anaphylaxis. Affected patients usually avoid the suspected drug in the future, but in selected cases the particular drug is essential for optimal therapy due to unavailable or ineffective alternative therapy. Under these circumstances, desensitization may be performed. Desensitization protocols have been developed and are used for antibiotics, sulfonamides, non-steroidal antiinflammatory drugs, insulins, biologic agents, and many others. Desensitization procedure is based on the induction of a temporary state of tolerance of a substance responsible for a hypersensitivity reaction. Gradually increasing doses of the drug are administered to the patient over several hours to a few days, until the total cumulative therapeutic dose is achieved and tolerated. Hypersensitivity to acetylsalicylic acid is a common indication to desensitization in a daily practice. A few protocols for this drug have been described. Recently, 7 patients hypersensitive to acetylsalicylic acid have been desensitized in our department due to cardiologic and rheumatologic reasons. In this group, desensitization procedures were performed successfully and the patients could continue pharmacotherapy with aspirin.
几乎任何药物都可能引起药物超敏反应，其临床严重程度差异很大，从轻度瘙痒、急性荨麻疹或血管性水肿到危及生命的过敏反应。受影响的患者通常在未来会避免使用可疑药物，但在某些特定情况下，由于没有可用的替代疗法或替代疗法无效，特定药物对最佳治疗至关重要。在这种情况下，可以进行脱敏治疗。已经制定了脱敏方案，并用于抗生素、磺胺类药物、非甾体抗炎药、胰岛素、生物制剂等多种药物。脱敏程序基于诱导对引起超敏反应的物质产生暂时的耐受状态。在数小时至数天内，逐渐增加药物剂量给予患者，直至达到并耐受总累积治疗剂量。对乙酰水杨酸过敏是日常实践中脱敏的常见指征。已经描述了针对这种药物的一些方案。最近，由于心脏和风湿性疾病的原因，我们科室对7名对乙酰水杨酸过敏的患者进行了脱敏治疗。在这组患者中，脱敏程序成功进行，患者可以继续使用阿司匹林进行药物治疗。
