What do patient's drug allergies tell you about them?

[AnthonyM83]

Was writing up some scenarios for the trainees and ended up giving sulfa allergy to a person with no pertinent medical history. Then wondered how the person would know of the allergy without history.

Obviously it's probably just be a common drug base and the fact they used it is almost insignificant like a lot other allergies, BUT just wondering if the fact someone is allergic to sulfa gives me any more information?

What about other drug allergies? Obviously someone who lists 8 pain medication allergies has some sort of pain issue and POSSIBLY a drug-seeking. But what other things could you get from allergies?

[Just Plain Ruff]

Codeine, sulfa, iodine and penicillin allergy - the patient is over 65 years old.

allegic to meperidine, hydrocodone, ketorolac and ibuprofen - and they know the actual names like ketorolac then they are drug seeking.

If they are allergic to all pain meds except hydromorphone- drug seeker

[Michael]

and they know the actual names like ketorolac then they are drug seeking

And how would you like your name-brand drug served today, Ruff?

[Just Plain Ruff]

i had a patient one day in the ER when I went to go give her toradol I told her I was giving her Ketorolac and she said "I'm allergic to that" When I asked her how she knew what ketorolac was she said she knew it was aspirin and that since she was allergic to aspirin she couldn't take it because she was allergic to aspirin. When I asked her if she was allergic to Toradol she said no I'm not allergic to that, I had that for my headache a week ago and it worked great. I told her it was the same thing. She then said "Nothing but demerol ever works for my headaches"

You had to know this person and their history to find it funny.

[firedoc5]

Drug allergies tell me what not to give to the patient. (just kidding

Sometimes when someone has had a medication too much they can develop an allergy to it. Like me, I can't take aspirin or Motrin anymore. I think I use to take those Goodies headache powders too much at one time. Now it will kick my asthma into gear. My father can't take penicillin anymore. He took it for many years with no problems, but after some dental work we found out that he apparently developed an allergy to it.

Many drug seekers are walking PDR's. I've known some that have got a hold of one and researched it quite well. They'll look up anything narcotic or any kind of "pain med" and get all the info they can so they can try to convince a doc that they had it before and that it is the only thing that works for them. They don't realize that they are just hanging themselves. Docs see a red flag when a "civilian" knows so much, too much.

[AnthonyM83]

What is iodine used for? thyroid disorders? what about sulfa drugs?

[spenac]

This patient would not consider the sinus infection five years ago as medical hx even though that is when he found out he was allergic to sulfa antibiotics. That information could change your choice of drugs from your box. While it is highly debated at times if a patient is allergic to sulfa they may also be hypersensitive to sulfates and sulfites. Many claim that they are totally unrelated yet I have seen several that react to all three including myself.

[Doczilla]

What is iodine used for? thyroid disorders? what about sulfa drugs?

Contrast agents for xray, CT scan, and angiography contain iodine, and this is the issue with this allergy and is usually how people find out that they are allergic to it. MRI contrast is gadollinium, and does not contain iodine, and is therefore safe for these patients. For this and other reasons, noncontrast CT is gaining wide use, even for intra-abdominal pathology. MRI is a reasonable alternative, though not typically available during off-hours.

On the OP's note, if a patient has more than 5 drug allergies, they have a high likelihood of having borderline personality disorder. There is a study out there to prove it, only I'm too lazy right now to look it up.

'zilla

[ladybear]

Doc.. I have been told that those with multiple allergies can also have inflammatory conditions they may not be diagnosed with, such as lupus and such.

I happen to be one of those who is allergic to multiple substances, most after I had a kid. When my last doc saw what I was allergic to he ordered several tests to rule out lupus and other inflammatory conditions. My ESR came back very elevated as well as a few other factors.

Being a guinea pig to treat migraines was part of how I learned I was allergic to several medicines.. the hard way. Bleh... :sad1:

[mrmeaner]

On the OP's note, if a patient has more than 5 drug allergies, they have a high likelihood of having borderline personality disorder. There is a study out there to prove it, only I'm too lazy right now to look it up.

'zilla

It's interesting you bring that up. One of the doctors on "Hopkins" made mention of a theory that alleries are based on experinces of childhood.