Managing and Preventing Drug Allergies: Insights from Prof. Liviu Oprea

Prof. Liviu Oprea, family doctor, president of the Romanian College of Physicians, Iași branch, explained to “Ziarul de Sănătate” that drug allergies exist, they are an unavoidable fact, they must be properly managed, but they are “extremely strange”.

From skin irritation to anaphylactic shock

The specialist said that, in principle, we can be allergic to most substances outside the human body, including medicines. “And drug allergies can vary in severity from anaphylactic shock, which is a fact, to integumentary skin allergies, which do not cause serious problems and usually disappear when the drug is stopped,” said Prof. Libiu Oprea.

He specified, however, that the practice of doctors is to include a small dose of those drugs that have a history in the scientific literature that they could give anaphylactic shock. The following period is when patients are kept under observation, although the doctor says that the allergic reaction can occur, although it is much rarer, also with subsequent doses, not only ‘ first or second.

“But it is a strict precaution, and if we are talking about anaphylactic shock and we see it happening, there is adrenaline in all DT surgeries and we can intervene to prevent to put on a more complicated situation. But it is very easy to prevent drug allergies: patients who think they have an allergy, or anyone in general, should not take drugs on their own without consulting their doctors. What we see very often is that patients have many more pills than we could ever recommend. Some are not even real medicines, they are food products, but they can also cause allergies”, said Prof. Libiu Oprea.

Antibiotics, with the greatest risk of allergy

The most frequent drugs that should be avoided in terms of the risk of a reaction are antibiotics, which have a greater potential for a wider allergy spectrum. But, says the president of the College of Doctors from Iși, there is also a great advantage of not taking antibiotics that you don’t need: the creation of an organism resistant to antibiotics is avoided.

Read the full edition of Health Gazette no. 5

“It would be important for patients to take only the drugs that are recommended for them. Additional material, as a rule, is not useful. And if some kind of drug allergy is involved, if it is not a severe form, a series of anti-allergy drugs and a more protein-free diet are recommended, together, of course, with stopping the drug that caused the allergy,” explained Dr. Libiu Oprea.

It is not often that a drug is so important that the patient has to take it, even if it develops a mild allergy for him, says Dr. Liviu Oprea. First, because there are other options on the pharmaceutical market that allow it to be replaced. But if other problems do not appear after the first symptoms of allergic reactions, it means that the patient will not develop a worse reaction than the first one.

Vaccine allergy, the opinion of many people “without plausible arguments”

“We have never had an anaphylactic shock in our offices, and we do not know of any patients who got it at our colleagues. We have patients who are known to be allergic to other things, such as bee stings, who are advised to have an epipen with them at all times. But no one in the office did as far as I know. I did not encounter the allergy to vaccination either, personally or among colleagues who worked in the vaccination centers. There have been these discussions, with people claiming that they are allergic or that they think they are allergic to the vaccine, but there is no plausible argument for that. Of course, we do not get involved in a discussion with patients, they can think what they want, but it is our duty to explain them as best as we can”, said Prof. Libiu Oprea.

Fever is the only major contraindication in the case of any kind of vaccination, the expert also said. For the rest, regardless of what patients are afraid of, whether they are getting vaccinated against influenza or with other serums, or they are vaccinating their children according to the national scheme, the recommendation is to stay 15 minutes after the medical procedure in the office, to see if they appear or not allergic reactions. “Which, although they can happen, are very rare,” concluded Prof. Libiu Oprea.