What is an Allergy?

When I pose this question, what I am referring to is the incessant questioning you receive from your pharmacy, your doctor, and heaven forbid you end up in the hospital. You might as well tattoo your allergy history on your forehead you get asked about it so often. With all of this practice, I would expect most of us would be very good at answering the question. However, I have noticed that a lot of people just don’t understand what an allergy is and why we ask.

What we are really trying to find out is whether or not you have had an allergic reaction to any medication in the past. There is a difference between an allergic reaction and a side effect from a medication. An allergic reaction is a systemic response that is characterized primarily by itching or a rash. These reactions usually start around your upper torso or face and can spread over large parts of your body. In the worst cases your face, lips, tongue, and throat can swell to the point where you are unable to breathe. This is a life threatening allergic reaction. THIS is what we are trying to avoid.

A lot of people mistake side effects for allergies. If the reaction I just described is not the reaction you have to a medication, then what you experienced is not an allergy and does not need to be listed as one. Codeine is a commonly listed allergy but, when asked about the reaction, many people say it upsets their stomach. Nearly 100% of people who list a codeine allergy will tell you that they “have no problem with” codeine’s cousin, the very popular hydrocodone. This is not an allergy. If something upsets your stomach, makes you sleepy, keeps you awake, gives you muscle pain, or any list of things besides the itchy rash, this is not an allergy.

I have had several people tell me that they know what they listed is not an allergy but they just want to make sure they don’t experience that side effect again. Listing that particular medication as an allergy will help ensure they never receive it again. That strategy works but here is the problem with it: it may also prevent you from receiving a related product that you need because we believe that will also trigger your allergy. For example, say you take Augmentin once and it gives you a terrible case of Montezuma’s revenge. You list that as an allergy to avoid Augmentin in the future. You have now ruled out all penicillin-based products even though Augmentin is the only one you have a problem with. You have also set yourself up to be questioned every time you receive a prescription for a related class, cephalosporins. You would be much better off, in this case, by just letting everyone know that you would prefer not to have the one product.

If you do experience an allergic reaction, in most cases, a simple dose of Benadryl or diphenhydramine will be all you need to stop it. It also might provide you with a nice nap (side effect of Benadryl).  You should immediately discontinue the medication that caused it and let your Doctor and pharmacy know to add that to your allergy profile. These reactions can get progressively worse so we want to be sure not to cause another reaction. If you have a severe reaction, immediate medical attention will be needed. Go to the ER or call 911 as soon as you notice swelling of lips, tongue, or difficulty breathing. These reactions are easily treatable if caught in time.

Think about this information and whether or not you need to give your allergy profile an update. Maybe you do. Food allergies might be important for your pharmacy to know as well. Peanuts, shellfish, and gluten allergies could be triggered by your medication.  Please leave your thoughts below. I would love to hear from you.