Improving detection and management of XXXX .

@entity1 @entity137 @entity6715 @entity114 @entity566 @entity56 @entity5143 @entity551 @entity2021
Suspected adverse drug reactions may be subdivided on the basis of mechanism e.g. immunological (requiring sensitisation by previous exposure) versus nonimmunological; timing (e.g. immediate or delayed), or whether the phenomenon is dose dependent or not. In the NICE guideline the main approach is to classify the event according to whether it: is immediate (within an hour of drug administration) or delayed (hours or days); affects a single or multiple systems; is clinically severe/life threatening or not. An immediate, immunologically mediated, multisystem, life-threatening reaction would for example include @entity2021 (type 1 or typically IgE- mediated @entity56 ) especially if the clinical features (e.g. @entity5143 , @entity551 ) are suggestive. Serum mast cell tryptase should be tested ideally within two hours and certainly before four hours post reaction. Detailed investigation of suspected cases in a specialist clinic is ideally delayed for 4-6 weeks after the event. @entity137 need to be meticulously recorded and the @entity1 fully informed. Documentation should include: date of reaction; drug name (chemical and generic); route of administration; time interval between first dose and event; and nature and severity of symptoms. Written guidance should be provided on which other chemically related drugs also need to be avoided. Specialist referral is indicated for: suspected @entity2021 ; severe/life- threatening episodes e.g. @entity6715 ; severe NSAID reactions with ongoing need for NSAID therapy; suspected @entity114 @entity566 (if alternative antibiotics are not available); and problems related to general and local anaesthesia.
