Outcomes and safety of drug provocation tests
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26
Tipo de produção
article
Data de publicação
2011
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OCEAN SIDE PUBLICATIONS INC
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AUN, Marcelo Vivolo
RODRIGUES, Adriana Teixeira
ENSINA, Luis Felipe Chiaverirti
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Citação
ALLERGY AND ASTHMA PROCEEDINGS, v.32, n.4, p.301-306, 2011
Resumo
Drug provocation tests (DPTs) are considered the gold standard for identifying adverse drug reactions (ADRs). The aim of this study was to analyze DPT results and discuss severe systemic reactions associated with them. This was a retrospective analysis of 500 patients with ADRs who sought treatment and were submitted to DPTs when indicated between 2006 and 2010. We performed DPTs according to the European Network for Drug Allergy recommendations. Single-blind, placebo-controlled DPTs were performed with antibiotics, local anesthetics, and nonsteroidal anti-inflammatory drugs, as well as with other drugs. Patient characteristics, DPT results, and reactions were analyzed. The sample comprised 198 patients (80.8% of whom were female patients) submitted to 243 DPTs. Ages ranged from 9 to 84 years (mean, 39.9 years). The 243 DPTs were performed with local anesthetics (n = 93), antibiotics (n = 19), acetaminophen (n = 44), benzydamine (n = 33), COX-2 inhibitors (n = 26), dipyrone (n = 7), aspirin (n = 4), or other drugs (n = 17). The results of 4 tests (1.6%) were inconclusive, whereas those of 10 (4.1%) revealed positive reactions to antibiotics (2/19), COX-2 inhibitors (2/26), acetaminophen (3/44), and local anesthetics (3/93). Two severe reactions were observed: cephalexin-induced anaphylactic shock and bupivacaine-induced anaphylaxis without shock. Four patients (2.0%) reacted to the placebo before administration of the drug. Drug provocation tests are safe for use in clinical practice but they should be placebo-controlled and should be performed under the supervision of an allergist. To confirm a presumptive diagnosis and to manage allergies appropriately, it is crucial to perform DPTs. (Allergy Asthma Proc 32:301-306, 2011; doi: 10.2500/aap.2011.32.3450)
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Referências
- Aberer W, 2003, ALLERGY, V58, P854, DOI 10.1034/j.1398-9995.2003.00279.x
- Bousquet PJ, 2008, CURR PHARM DESIGN, V14, P2792, DOI 10.2174/138161208786369731
- Pichichero ME, 2007, OTOLARYNG HEAD NECK, V136, P340, DOI 10.1016/j.otohns.2006.10.007
- Romano A, 2007, CURR OPIN ALLERGY CL, V7, P299
- DePestel DD, 2008, J AM PHARM ASSOC, V48, P530, DOI 10.1331/JAPhA.2008.07006
- Demoly P, 1999, ALLERGY, V54, P999, DOI 10.1034/j.1398-9995.1999.00247.x
- Johansson SGO, 2004, J ALLERGY CLIN IMMUN, V113, P832, DOI 10.1016/j.jaci.2003.12.591
- Messaad D, 2004, ANN INTERN MED, V140, P1001
- Antunez C, 2006, J ALLERGY CLIN IMMUN, V117, P404, DOI 10.1016/j.jaci.2005.10.032
- Torres MJ, 2003, ALLERGY, V58, P961, DOI 10.1034/j.1398-9995.2003.00280.x
- Brockow K., 2002, Allergy (Copenhagen), V57, P45, DOI 10.1034/j.1398-9995.2002.13027.x
- Demoly P, 2002, ALLERGY, V57, P37, DOI 10.1034/j.1398-9995.57.s72.7.x
- Dietrich JJ, 2009, ALLERGY ASTHMA PROC, V30, P69, DOI 10.2500/aap.2009.30.3195
- Hermes B, 2006, J EUR ACAD DERMATOL, V20, P800, DOI 10.1111/j.1468-3083.2006.01634.x
- McClimon B, 2011, ALLERGY ASTHMA PROC, V32, P95, DOI 10.2500/aap.2011.32.3417
- Meissner K, 2007, BMC MED, V19, P5
- Nagao-Dias AT, 2009, ALLERGOL IMMUNOPATH, V37, P98
- Nettis E, 2001, ORAL SURG ORAL MED O, V91, P402, DOI 10.1067/moe.2001.113348
- Otto HF, 2010, ALLERGY ASTHMA PROC, V31, P244, DOI 10.2500/aap.2010.31.3331
- Palma-Carlos S, 2007, REV PORT IMUNOALERGO, V15, P485
- Pichichero ME, 2007, DIAGN MICR INFEC DIS, V57, p13S, DOI 10.1016/j.diagmicrobio.2006.12.004