Adverse Drug Reaction (ADR)

Medicines or drugs are taken by a person for treatment or prophylaxis of a particular disease. Whenever a drug is administered, it shows its desired pharmacological response in the patient’s body. However there are conditions when at doses usually used in patients for the prophylaxis, diagnosis or therapy of disease or for modification of physiological function, drug alone or in combination with other drugs shows noxious and unintended response. These are known as Adverse Drug Reactions. This unexpected response of the drug on humans and animals can be one of the reasons for morbidity and mortality of patients.

One such example is of Penicillin, which is the first antibiotic discovered by Alexander Flemming in 1828. Penicillin belongs to an important class of antibiotics called as β-Lactum antibiotics. Penicillin G, penicillin V, benzathine penicillin, procaine penicillin, as well as over 15 related compounds with broader antibacterial effects are part of penicillin family of antibiotics. It is widely used as it is relatively inexpensive and is effective in eradication of common bacterial infections such as to treat pneumonia, meningitis, endocarditis so on and so forth. Common adverse reactions associated with the use of penicillin include diarrhoea, rash, neurotoxicity, urticaria. Infrequently, patient may produce fever, vomiting, erythema, dermatitis, angioedema or seizures. However some patients (approximately 0.01%) may experience hypersensitivity reactions.

The most common allergies to penicillin are the type I and type IV hypersensitivity reactions. Type I hypersensitivity reactions are mediated by IgE which is considered as serious allergic reaction. High-dose parenteral administration and repetitive or frequent dosing of penicillins are the risk factors for type I reactions. Reactions which occur between the ages of 20 to 49 years are considered as the most severe reactions. It is vital to determine the time of administration, route of medication, as well as the onset and type of symptoms which include respiratory difficulty, gastro intestinal symptoms, changes in mental status, cardiovascular stroke and hypotension.

To avoid such allergic reactions Penicillin skin test is done. It is a means used in the diagnosis of penicillin allergy. In this test, a small amount of the penicillin is administered with a tiny needle to the patient’s skin by the allergist or nurse. A red, itchy, raised bump specifies a positive reaction to the test indicating a high probability of penicillin allergy. A negative test result frequently represents a low risk of allergy to penicillin. Nonetheless, a negative result is quite tough to infer since, some types of drug reactions cannot be detected by skin tests.

Hence, it is in the hands of the healthcare professionals to save the lives of the patients who could be allergic to any of the drugs. It could be a known allergy or could be one which has not been reported. During each and every admission of patient to the hospital, the health care workers always enquire for allergies as even a minor negligence could lead to serious consequences. Pharmacists check the patient medication record, check for crossover allergic reaction, and evaluate the safety of prescribed drugs in conjunction with the other drugs. Nursing staff are constantly vigilant while dose administration. These interprofessional steps prevent drug allergies and prevention is the ideal strategy for management and pharmacy students make well aware for this in top pharmacy colleges.

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