Department of Dermatology und Allergology Biederstein, Technical University of Munich, Munich, Germany.
Department of Dermatology, Medical University of Graz, Graz, Austria.
Allergy. 2016 Nov;71(11):1533-1539. doi: 10.1111/all.12929. Epub 2016 Aug 14.
The strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
药物过敏(DH)最强和最有记录证明的风险因素是先前反应的病史。在致敏患者中,药物的意外接触可能导致严重甚至致命的反应。可预防的处方错误很常见。它们通常是由于病史不足或对药物反应复发的风险评估不佳所致。适当的记录是医生做出合理治疗决策的重要信息。欧洲药物过敏网络和欧洲过敏与临床免疫学学会药物过敏兴趣小组已经成立了一个工作组,制定了药物过敏护照以及药物过敏记录的一般指南。药物过敏护照、药物过敏警示卡、证书和医疗评估后的出院信是记录患者 DH 的充分手段。应将这些文件交给患者,建议患者随时携带,特别是在离家外出时。药物过敏护照应至少包含有关罪魁祸首药物(包括国际非专利名称)的信息,包括临床表现(包括严重程度)、诊断措施、潜在的交叉反应、可开处方的替代药物以及从签发人处获取更多详细信息的途径。只有在进行全面过敏检查后,才能将其交给患者。将来,具有警示功能的电子处方系统将变得更加普遍,并且应包含与基于纸张的文档相同的信息。