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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Pseudoallergic and allergic reactions to nonsteroidal antiinflammatory drugs (NSAIDs)

Pseudoallergic and allergic reactions to nonsteroidal antiinflammatory drugs (NSAIDs)
Type Eliciting NSAID Signs and symptoms Timing of onset of signs/symptoms Patient comorbidities
Pseudoallergic NSAID reactions:
  • Elicited by multiple NSAIDs (including aspirin) in a susceptible patient
  • Related to the pharmacologic ability of NSAIDs to inhibit COX-1 enzyme
Type 1 Multiple (including aspirin) Common:
  • Severe rhinitis, nasal obstruction
  • Bronchospasm
  • Conjunctival injection
  • Facial flushing

Uncommon:

  • Throat tightness/laryngospasm
  • Nausea/vomiting
  • Diarrhea
  • Hypotension
 Delayed: 30 minutes to 3 hours after ingestion or administration
  • Asthma (present in most but not all patients)
  • Chronic rhinosinusitis with nasal polyposis (patients usually have extensive sinusitis on CT and often report anosmia)
  • AERD*
Type 2 Multiple (including aspirin) Urticaria and/or angioedema 30 to 90 minutes Chronic urticaria (patients may report being able to tolerate NSAIDs when urticaria is in remission)
Type 3 Multiple (including aspirin) Urticaria and/or angioedema 30 to 90 minutes None
Type 4 Multiple (including aspirin) Symptoms affecting both the respiratory tract and skin. Includes patients with AERD who develop cutaneous symptoms in the context of respiratory reactions. Variable depending upon the type of reaction: 30 to 90 minutes
  • Some patients have AERD and experience systemic reactions with cutaneous symptoms
  • Other patients have no underlying conditions
Allergic NSAID reactions:
  • Elicited by a single NSAID (or rarely by more than one agent with very similar structure) in a susceptible patient
  • Not reported with aspirin
  • Presumed to be IgE mediated
Type 5 A single NSAID (not aspirin) Cutaneous: Urticaria, pruritus, angioedema Variable: Minutes to a few hours after ingestion/administration None
Type 6 A single NSAID (not aspirin) Anaphylaxis (probably a more severe form of type 5) Variable: Minutes to a few hours after ingestion/administration None

COX: cyclooxygenase; CT: computed tomography; AERD: aspirin-exacerbated respiratory disease; IgE: immunoglobulin E.

* AERD refers to the triad of asthma, chronic rhinosinusitis with nasal polyposis, and aspirin (or NSAID) induced type 1 pseudoallergic reactions.
Graphic 90304 Version 19.0

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