NAV

Allergy Details

Allergy Detail Overview

An “allergy detail” includes available information regarding hypersensitivity (allergic) reactions patients may experience following the administration of a drug. Allergy details may be specific to a drug or may be retrieved for a drug from an allergy category.

Each allergy detail is associated with real-world evidence documenting specific allergic reactions following administration of the relevant drug. Therefore, possible presentations of drug allergy are based on documented clinical evidence. Significantly, allergic reactions vary widely between drugs and individual patients. Because of this, It is possible for a patient to experience a specific allergic reaction (presentation) to a drug even when the presentation is not listed under our allergy detail entry.

Allergy detail entries contain several fields that provide information about the possible allergic presentations, the evidence for these presentations, and a short description summarizing allergic reactions.

Allergy Detail Summary

Every allergy detail has a summary field that includes an overview of the known allergic presentations for the drug in question. If the detail is based on an allergy category, the category will be indicated in parentheses following the drug name.

Allergy Detail Info

The info field provides an overview (1-3 paragraphs) of relevant information regarding allergic reactions to the drug in question. If the allergy detail info for a drug comes from a category, the info will reference the category name and not the specific drug name.

The data provided in each info section varies depending on data within the literature. Specific information from case reports or similar clinical reporting is described, which may include clinical presentations. If one or a few presentations are especially common, these are emphasized. If information regarding the frequency of allergic reactions to a drug is known, this is provided. Finally, if specific guidelines for allergy testing are mentioned in the literature, these are also summarized.

In some cases, drugs are frequently/only prescribed in combination with other drugs (e.g., trimethoprim and sulfamethoxazole). Allergic reactions in patients taking combinations of drugs can be difficult to assign to a single drug. In such cases, this is explained in the info section of each specific drug within the combination.

Allergy Detail Evidence Type

The evidence_type field returns a list of tags indicating the kinds of sources that the provided information is drawn from. Possible values are:

Evidence TypeDescription
clinical_trialData comes from a controlled clinical trial
post_marketingData comes from post-approval marketing surveillance
uncontrolled_trialData comes from an open study without a comparator/placebo
nonclinical_trialData comes from a cohort study, case-control study, or a retrospective medical record review
case_reportsData comes from a detailed description of one or more cases
varying_reportsData does not easily fit into other resource types or is based on a combination of resources
reviewData comes from a review article; the primary data discussed may be from any other type of source
literatureData comes from the literature
unclassifiedData source not easily classified

Allergy Detail Hypersensitivity Types

The hypersensitivity_types property returns a non-redundant list of all hypersensitivity types associated with specific presentations for an allergy detail. These types are explained in the allergy classification section. This list allows for a quick overview of the underlying cause of allergic reactions to a given drug. For example, if only Type IV was listed, it is possible to infer that most reactions to the drug in question are caused by delayed T-cell mechanisms. It is common for multiple hypersensitivity types to be listed for each allergy detail. This is due to various mechanisms that commonly cause allergic (hypersensitivity) reactions to a given drug or category.

Allergy Details Presentations

The presentations field returns a list of allergy presentations that have been documented to occur when a given drug/category is administered.

Allergy Details Structure

[
  {
    "drug": {
      "drugbank_id": "DB00316",
      "name": 
"Acetaminophen"
}, "details": [ {
"summary": "Hypersensitivity to Acetaminophen can present as: fixed drug eruptions, Pruritus, Anaphylaxis, Cutaneous Manifestations of Drug Allergy, Angioedema, Acute Generalized Exanthematous Pustulosis, Allergy-Induced Respiratory Symptoms, Urticaria, Nonimmunologic Anaphylaxis, and Stevens-Johnson Syndrome Toxic Epidermal Necrolysis Spectrum",
"info": "In literature, both anaphylaxis and anaphylactoid reactions have been reported with the use of acetaminophen. Cases of local and generalized urticaria and angioedema have been reported.[A222799,T803]
According to a Tunisian retrospective study, the most common hypersensitivity reactions to acetaminophen were urticaria (34.4%), macular and pustular eruption (30.2%), and fixed drug eruption (12.6%).[A222804] Other presentations include dyspnea, rhinitis, conjunctivitis, pruritus, erythema, cough, and abdominal pain.[A222819]
Uncommon reactions included Lyell syndrome, anaphylactic shock,[A222804] Stevens-Johnson syndrome, toxic epidermolysis,[A222809] as well as rare cases of acute generalized exanthematous pustulosis (AGEP).[T803] About 1.6% of clinical features of allergy such as angioedema, urticaria, and bronchospasm, are considered non-immunological hypersensitivity reactions, as they are caused by the pharmacological action of COX‑1 inhibition by acetaminophen. True immediate- (IgE-mediated) and delayed-type (T cell-mediated) hypersensitivity reactions to acetaminophen tend to be rare in clinical practice.[A222809]",
"evidence_type": [ "review"
],
"hypersensitivity_types": [ "Type I", "Type IV", "Unclassified"
],
"presentations": [ "Acute Generalized Exanthematous Pustulosis", "Allergy-Induced Respiratory Symptoms", "Anaphylaxis", "Angioedema", "Cutaneous Manifestations of Drug Allergy", "Nonimmunologic Anaphylaxis", "Pruritus", "Stevens-Johnson Syndrome Toxic Epidermal Necrolysis Spectrum", "Urticaria", "fixed drug eruptions"
] } ] } ]
In this structure, we are reviewing the allergy details for acetaminophen. This structure can be interpreted like this:

"According to a reviewed article(s), acetaminophen has presented hypersensitive reactions in the form of Actue Generallized Exanthematous Putulosis, Allergy-Indiced Resiratory Symptomes, Anaphylaxis, Andioedema… This information is also available in the “summary” attribute of the response. From the reviewed article(s), these reactions are Type I immediate hypersensitivity reactions, type IV delayed hypersensitivity reactions, or are not classifiable as one of the four hypersensitivity types (“Unclassified”). According to a Tunisian retrospective study, the most common hypersensitivity reactions to acetaminophen were urticaria (34.4%), macular and pustular eruption (30.2%), and fixed drug eruption (12.6%).[A222804] Other presentations include dyspnea, rhinitis, conjunctivitis, pruritus, erythema, cough, and abdominal pain.[A222819]."