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Chemistry of drug allergenicity

Chemistry of drug allergenicity Of the very large number and variety of drugs used in medicine, those that are frequently implicated in immediate allergic reactions are relatively small in number and include neuromuscular blocking drugs used in anaesthesia, β-lactam antibiotics, some other antibacterial agents including broad-spectrum antibiotics and quinolones and, less often, some narcotics. Structure-activity and immunochemical investigations have been most numerous and detailed for neuromuscular blocking drugs and β-lactams, particularly penicillins. For the former group of drugs, morphine is proving to be a useful agent for the in-vitro detection of clinically relevant neuromuscular blocking drug- as well as morphine- and fentanyl-reactive IgE antibodies. The employment of so-called ‘major’ and ‘minor’ determinants for a range of different penicillins and cephalosporins has revealed previously unsuspected heterogeneity in patient recognition responses, and has reinforced findings on the allergenic importance of side-chain groups. Many reports have been published on anaphylaxis to chlorhexidine, and progress in identifying allergenic determinants is reviewed together with the still inadequately understood subject of IgE antibody recognition of quinolone antibacterial agents. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Opinion in Allergy and Clinical Immunology Wolters Kluwer Health

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Copyright
Copyright © 2001 by Lippincott Williams & Wilkins. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without either the prior written permission of the Publisher or a licence permitting restricted copying issued in the UK by the Copyright Licensing Authority and in the USA by the Copyright Clearance Center. Applications for permission should be addressed to the International Rights Department, Lippincott Williams & Wilkins, 227 East Washington Square, Philadelphia, PA 19106-380, USA, or faxed to (+1) 215 238 4419. 1528-4050/01.
ISSN
1528-4050
eISSN
1473-6322

Abstract

Of the very large number and variety of drugs used in medicine, those that are frequently implicated in immediate allergic reactions are relatively small in number and include neuromuscular blocking drugs used in anaesthesia, β-lactam antibiotics, some other antibacterial agents including broad-spectrum antibiotics and quinolones and, less often, some narcotics. Structure-activity and immunochemical investigations have been most numerous and detailed for neuromuscular blocking drugs and β-lactams, particularly penicillins. For the former group of drugs, morphine is proving to be a useful agent for the in-vitro detection of clinically relevant neuromuscular blocking drug- as well as morphine- and fentanyl-reactive IgE antibodies. The employment of so-called ‘major’ and ‘minor’ determinants for a range of different penicillins and cephalosporins has revealed previously unsuspected heterogeneity in patient recognition responses, and has reinforced findings on the allergenic importance of side-chain groups. Many reports have been published on anaphylaxis to chlorhexidine, and progress in identifying allergenic determinants is reviewed together with the still inadequately understood subject of IgE antibody recognition of quinolone antibacterial agents.

Journal

Current Opinion in Allergy and Clinical ImmunologyWolters Kluwer Health

Published: Aug 1, 2001

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