Bernstein J A
Department of Internal Medicine, University of Cincinnati College of Medicine, USA.
Postgrad Med. 1995 Jul;98(1):120-2, 125-6.
When a patient experiences an adverse drug reaction, the history is in most instances the only clinical tool available for establishing a diagnosis. Thus, when taking a history, physicians should always inquire about drugs the patient has been taking and prior reactions to drugs. Clinicians should characterize every adverse drug reaction according to an accepted classification system. Familiarity with the types of reactions discussed here is therefore essential. The majority of adverse drug reactions are nonimmunologic in origin, and the most common reactions occur in response to relatively few classes of drugs. It is important not to incorrectly label a reaction as allergic, since this implies an immune-mediated response, which often precludes future use of the drug. On the other hand, if there is any concern that a reaction may be allergic, it is best to err on the side of caution by using an alternative, non-cross-reacting drug for treatment.
当患者发生药物不良反应时，在大多数情况下，病史是用于确诊的唯一临床工具。因此，在采集病史时，医生应始终询问患者正在服用的药物以及既往的药物反应。临床医生应根据公认的分类系统对每一种药物不良反应进行特征描述。因此，熟悉此处讨论的反应类型至关重要。大多数药物不良反应起源于非免疫性，最常见的反应是由相对较少种类的药物引起的。重要的是不要将反应错误地标记为过敏，因为这意味着免疫介导的反应，这通常会排除该药物的未来使用。另一方面，如果担心反应可能是过敏反应，最好谨慎行事，使用替代的、无交叉反应的药物进行治疗。
