$Unique_ID{BRK00553} $Pretitle{} $Title{Is There a Rule to Figure Out if One is Having a Drug Reaction?} $Subject{skin rash drugs medicines reactions Ill Defined Symptoms symptom cosmetics perfumes soaps reaction Hives urticaria anaphylaxis intense itching tingling lips wheezing breathing shock morbilliform measles-like erythema multiform amoxicillin sulfonamides penicillins barbiturates nonsteroidal anti-inflammatory drugs NSAID digoxin antacids acetaminophen nitroglycerin prednisolone} $Volume{N-20} $Log{} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Is There a Rule to Figure Out if One is Having a Drug Reaction? ------------------------------------------------------------------------------ QUESTION: I know that reactions to new medications and drugs frequently take the form of skin rashes. I have a delicate, light complexioned skin, and am always breaking out in one way or another. Is there some simple or exact rule that I can use to figure out if I am having a drug reaction? ------------------------------------------------------------------------------ ANSWER: I wish it were that simple, but unfortunately I can only give you some general considerations to use, and advise you to keep a attitude of suspicion alive when ever you are starting on a new medication. Also remember that new cosmetics, perfumes, soaps, in fact any chemical that comes in contact with your skin, as well as new foods taken into the body, may cause similar reactions. The first and certainly most important clue is the history. Any new medication must be evaluated as a possible cause of a new skin rash, and should, with the doctor's approval, be discontinued. Most drug reactions will begin within the first two weeks after starting to take it. Even if the drug had been taken without problems some time in the past, it is possible that your immune system has changed over time, and that this time a reaction has occurred. Though skin reactions may take many forms, there are three which are most common. Hives (or urticaria) are the most common, and can occur within minutes to hours after a new drug has been taken. In other cases they may first appear in 12 to 36 hours after the first dose. They are red, wheal like lesions which usually are short-lived and will remain evident for about 10-12 hours. However they may be just a prelude to a life threatening condition known as anaphylaxis, which may start with intense itching, tingling of the lips, wheezing and breathing difficulty, leading to shock. Immediate medical treatment is necessary when these symptoms occur. The other two commonly seen rashes are morbilliform (or measles-like) and erythema multiform (which usually is a target like lesion with concentric reddened rings around a dark red center). The most common medications producing rash reactions are amoxicillin, sulfonamides and penicillins, as well as blood products, barbiturates and nonsteroidal anti-inflammatory drugs (NSAIDs). Medications least likely to produce reactions are digoxin, antacids, acetaminophen, nitroglycerin and prednisolone. You may have to use all your talents as a "drug detective" to identify the culprit in your case. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.