del Río-Navarro B E, Sol-Monterrey E G, Sienra-Monge J J
Departamento de Neumología, Hospital Infantil de México Federico Gómez, D.F.
Bol Med Hosp Infant Mex. 1993 Jul;50(7):520-5.
Adverse reaction to drugs are classified as immunological and non-immunological. It is consider that one to five percent of the general population reactions to drugs. Allergic reactions are the most intense and dangerous, but they represent only five to ten per cent of all of them. Immunological adverse reactions may be induced by the drug or by their metabolites. There are risk factors to induced allergic reactions such as doses, administration time and way of administration. The four mechanism of damage from Gell and Coombs are discussed regarding to drugs, stressing the penicillin issue. Other common drugs reactions in the diary practice are cutaneous reactions with unknown immunological mechanism as it happens in febrile mucocutaneous syndrome and the phototoxic and photoallergic reactions. Pseudoallergic or "anaphylactoid" reactions have signs and symptoms like those of anaphylaxis, but the mechanism of damage is not immunological, as with local and general anesthetics and radiopaque media. Treatment for any adverse events is to stop the administration as soon as possible. The drug of choice is 1:1000 subcutaneous adrenaline besides colloid solutions, steroids and antihistaminics.
药物不良反应分为免疫性和非免疫性。据认为，普通人群中1%至5%的人会对药物产生反应。过敏反应最为强烈和危险，但在所有不良反应中仅占5%至10%。免疫性不良反应可能由药物或其代谢产物诱发。诱发过敏反应存在一些风险因素，如剂量、给药时间和给药方式。针对药物讨论了盖尔和库姆斯的四种损伤机制，重点是青霉素问题。日常医疗实践中其他常见的药物反应是免疫机制不明的皮肤反应，如发热性黏膜皮肤综合征以及光毒性和光过敏反应。假过敏或“类过敏”反应具有与过敏反应相似的体征和症状，但损伤机制并非免疫性，如局部和全身麻醉剂以及造影剂所致。对于任何不良事件的治疗是尽快停止给药。除胶体溶液、类固醇和抗组胺药外，首选药物是1:1000皮下注射肾上腺素。
