Beta Lactam Allergy Flashcards
Type I Reaction
Hypersensitivity (Onset < 1 hour)
- Bronchoconstriction
- Urticaria
- Angioedema
- Allergic Rhinitis
- Diarrhea
Type II Reaction
Cytotoxic (Onset > 72 hours)
- From High Dose Therapy, cell destruction
- Hemolytic Anemia
- Thrombocytopenia
- Leukopenia
- Neutropenia
Type III Reaction
Immune Complexes (Onset 7-14 days)
- Complexes lodge in tissue site and induce complement system
- Interstitial nephritis
- Serum sickness
- Allergic vasculitis
- Drug fever
Type IV Reaction
Cell Mediated (Onset Delayed)
- Activation of macrophages and cytotoxic t cells
Contact Dermatitis (24-48 hours)
Maculopapular Rash (>72 hours)
Group 1 Cross Allergy
Penicillin
Cefoxitin
Group 2 Cross Allergy
Amoxicillin
Ampicillin
Cefadroxil
Cephalexin
Cefprozil
Group 3 Cross Allergy
Cefotaxime
Ceftriaxone
Cefepime
Group 4 Cross Allergy
Cefuroxime
Cefoxitin
Group 5 Cross Allergy
Ceftazidime
Ceftolozane
Aztreonam
Managing Beta Lactam Allergy
Data Collection
- Specific agent (Drug + Route)
- Date of Reaction
- Timing and Onset
- Description and Management
- Concurrent Medications
- Exposure to any Beta Lactams since
- Documentation
If True IgE mediated reaction to penicillin
Hives, Hypotension, Respiratory difficulty
- Can use other dissimilar side chains or Carbapenem
If Severe Non-IgE mediated to penicillin
Type II or Type III or IV
- Avoid all beta-lactams
If True IgE mediated reaction by cephalosporin
Hives, Hypotension, Respiratory difficulty
- Can use other dissimilar side chains or Carbapenem
If not-severe or is IgE mediated
Safe to administer other beta-lactams
Skin Testing
ONly predicts Type I reactions
When should drug tolerance (desensitization) be done
Only in severe, IgE mediated reactions
OR
Skin Test Positive
