Cross-reactivity among drugs: Clinical problems

Antonino Romano, Rosa Maria Guéant-Rodriguez, Marinella Viola, Francesco Gaeta, Cristiano Caruso, Jean Louis Guéant

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Cross-reactivity among drugs is either mediated by immunologic mechanisms or not. The former kind is usually explained by the presence of common antigenic determinants in the cross-reacting drugs. In the case of compounds provoking non-allergic hypersensitivity reactions, cross-reactivity is explained by a common pharmacological characteristic, such as the inhibitory effect of non-steroidal anti-inflammatory drugs on cyclooxygenase-1 and the capability of muscle relaxants or contrast media to release histamine through a non-immunologic mechanism. The main clinical problem deriving from cross-reactivity among drugs is the compelling need to choose a potentially cross-reactive compound and, therefore, to assess cross-reactivity by diagnostic tests. In choosing alternative compounds, skin testing has been used in evaluating IgE-mediated cross-reactivity between penicillins and cephalosporins, as well as among muscle relaxants. In assessing T cell-mediated cross-reactivity among contrast media, corticosteroids, anticonvulsants and heparins, delayed-reading intradermal tests and patch tests, together with lymphocyte transformation tests, can be performed. Because of the limited sensitivity of in vivo and in vitro testing, the most prudent way of establishing the tolerability of a compound of the same group in patients who especially require one is a graded challenge when other allergologic tests are negative.

Original languageEnglish
Pages (from-to)169-179
Number of pages11
JournalToxicology
Volume209
Issue number2
DOIs
Publication statusPublished - Apr 15 2005

Fingerprint

Pharmaceutical Preparations
Contrast Media
Muscle
Intradermal Tests
Muscles
Cyclooxygenase 1
Patch Tests
T-cells
Lymphocytes
Histamine Release
Cross Reactions
Testing
Cephalosporins
Lymphocyte Activation
Routine Diagnostic Tests
Penicillins
Anticonvulsants
Immunoglobulin E
Histamine
Heparin

Keywords

  • Beta-lactam antibiotics
  • Cross-reactivity
  • Drugs
  • Hypersensitivity reactions
  • IgE
  • Quinolones
  • Radio contrast media
  • T cells

ASJC Scopus subject areas

  • Toxicology

Cite this

Romano, A., Guéant-Rodriguez, R. M., Viola, M., Gaeta, F., Caruso, C., & Guéant, J. L. (2005). Cross-reactivity among drugs: Clinical problems. Toxicology, 209(2), 169-179. https://doi.org/10.1016/j.tox.2004.12.016

Cross-reactivity among drugs : Clinical problems. / Romano, Antonino; Guéant-Rodriguez, Rosa Maria; Viola, Marinella; Gaeta, Francesco; Caruso, Cristiano; Guéant, Jean Louis.

In: Toxicology, Vol. 209, No. 2, 15.04.2005, p. 169-179.

Research output: Contribution to journalArticle

Romano, A, Guéant-Rodriguez, RM, Viola, M, Gaeta, F, Caruso, C & Guéant, JL 2005, 'Cross-reactivity among drugs: Clinical problems', Toxicology, vol. 209, no. 2, pp. 169-179. https://doi.org/10.1016/j.tox.2004.12.016
Romano A, Guéant-Rodriguez RM, Viola M, Gaeta F, Caruso C, Guéant JL. Cross-reactivity among drugs: Clinical problems. Toxicology. 2005 Apr 15;209(2):169-179. https://doi.org/10.1016/j.tox.2004.12.016
Romano, Antonino ; Guéant-Rodriguez, Rosa Maria ; Viola, Marinella ; Gaeta, Francesco ; Caruso, Cristiano ; Guéant, Jean Louis. / Cross-reactivity among drugs : Clinical problems. In: Toxicology. 2005 ; Vol. 209, No. 2. pp. 169-179.
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