Every week I see allergy lists that include many things that do not elicit a true allergic reaction. Sometimes it's a side effect or unrelated reaction that has prompted the patient to list the item as an allergy. For example; percocet - nausea, keflex - yeast infection, benadryl - sleepy. I've even seen meds listed where the reaction is actually the desired effect such as Lasix - makes me pee a lot.
We can educate patients until we're blue in the face that a certain reaction is not a life threatening allergic reaction but unless it's listed they don't think their concerns and needs are being heard. The problem with one list, even if the reaction is listed, is sometimes we still have to give the med even though the patient listed it as an allergy. I had one patient who listed virtually every narcotic as an allergy due to headache, nausea, diarhea, hallucinations, or itching. Pretty much just one reaction per drug. My pain orders were for demerol IV but demerol was listed as an allergy and yes the doctor knew of the long allergy list. When the patient asked for pain medicine I explained that my order was for demerol and she'd listed that as an allergy. She said, "It's only an allergy when I swallow the pill, injected is okay. " :selfbonk:
So I documented the conversation and treated her with IV demerol with no adverse reactions.
I think we need a new category that we can put meds into, perhaps label it intollerance. Patients know what drugs they don't want to use but sometimes the med they don't like is the best option for treating their condition.
By listing intollerances we can understand problems they've had with meds and keep the really dangerous things in a separate listing.