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

[AnthonyM83]

If you're talking emotional experience . . . I've seen some weird non-mainstream psych stuff that claims that and uses to explain the "clearing" of allergies with psych/therapy treatments (I've talked to people whom this has worked on)...but haven't found any science on it, yet.

If you're talking physical experiences . . . yes, there's studies relating cats and eggs and milk and stuff like that during childhood with presence or lack of development of certain allergies.

[Baylor]

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.

I saw that too. That doc cracks me up. I wonder what he's like to work with in person. As far as drug allergies, my step-mom who I call a freak of nature is allergic to most all pain meds and doesn't take hardly anything, even after her multiple surgeries. She's also got a huge list of non-med allergies also (cats, sulfites, etc). I'll be sure to tell her that she has BPD. :wink:

[Richard B the EMT]

I would be a bit slower on "identifying" any individual as a drug seeker, simply because they know generic names for pain killers. I know a bunch of stuff (and presume many of the "city dwellers" do, too) because I read a lot, and watch Jeopardy!

I also admit there is the possibility they might be drug seekers, but, without any further information to go on, I'll simply give the usual advisement of doing it "Case by case).

[ncmedic309]

I also find it important to determine the type of reaction that the patient had to the medication. I find that a lot of people will tell you that they are allergic to "x" drug and upon determining the reaction they had to that medication - it wasn't an allergic reaction. In these cases the patient labels it an allergic reaction when it was only a common side effect.

I try to give everybody the benefit of the doubt, but if you have a pain complaint and tell me that your allergic to Tylenol, Ibuprofen, Aspirin, Naproxen, Toradol, (insert drug here that doesn't produce a "high") - you've just convinced me that your after pain meds and won't be receiving anything from me.

[Don1977]

Ruff-The four allergies you named are the 4 most common ones I see with my patients.

PCN is actually a allergy with at least 1 out of every 4 patients

[Ridryder 911]

Ruff-The four allergies you named are the 4 most common ones I see with my patients.

PCN is actually a allergy with at least 1 out of every 4 patients

Then you ask them what it does, they will say they have never taken it :shock: ...

Allergies is big clue as well as type of history they may have. Albeit substance abuse, treated for mental health, seizures, chronic pain, cancer, etc... similar to the medicine that are taking.

Just as important to know the allergies is what do they consider the allergy to present? Most are NOT true allergies rather are side effects of the medication.... i.e. Codeine=nausea, Lortab=vertigo,nausea..etc..

[Musicmedic5150]

The main allergies I have seen are PCN, Codeine, Sulfa drugs and ASA.

[firedoc5]

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:

I'm in the same boat. My migraines are now pretty much under control, but they used me for all sorts of trials with meds and treatments when I was getting them very frequently. At one time I was getting three every two weeks on average. I found out real quick I couldn't have Torodol (also for kidney stones). Immitrex worked great, thought it was a miracle drug and that I had it made. But the third time I had it I had crushing chest pain, went into a PSVT and my blood pressure rocketed. They said no more for you.

I have about nine allergies. Some are really adverse reactions other than true allergies, but when they ask for allergies you have to tell them all. I like to describe what happens when I have them.

[mrsbull]

This post has it's points but I now think about when I went to the drs 2 days ago for my knees. I have a hx of knee probs.

I am allergic to asa, I have had GBP and there for it is contraindicated to have ibuprophen in GBP pts because of the risk of ulcers and the change in anatomy. Subsequently from the bypass my pancreatic enzymes are higher and my alts are elevated. I am not to take tylenol either because it does not help my liver. I sure as hell am not a drug seeker. I know it likely looks like it, but I got an anti inflamatory that is awesome. So no pain killers for me.

This post has me concerned a bit tho. I understand there is significant amount of drug seekers, and it can be easy or hard to spot. However if I was a pt of someone on this board (or anyones pt for that matter) I likely would be treated as a seeker and not given the amnt of care I deserve.

That said it is a little odd that someone would be "allergic" to ALL forms of non "high" producing meds. However it can be contraindicated in someone such as myself. Not that I have an allergy to them. I sure will take some if that is all that is available at the time. Usually it is within something ie day-quil. I do try to keep away from it.

Use your judgement please do not assume. Do research on what your pts tell you it might be BS or it might be helpful and it never hurts to learn something new. You might see that pt again and actually call their bluff OR you might actually be able to give the pt better care because you are informed about something new.

[Richard B the EMT]

Speaking strictly as a BLS provider, I am aware that if an individual is taking "Medicine 'A'", taking a "Medicine 'B'" can be contraindicated, so allergies may not be in play at all. Rather than telling us they have contraindications, sometimes the patients will phrase it to us as an allergy, like the often joked about patient on Phenobarbital who tells us he's taking "peanut butter balls".