Is There a Rule to Figure Out if One is Having a Drug Reaction?

Is There a Rule to Figure Out if One is Having a Drug Reaction?

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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?
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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.