You are NOT allergic to...

[BuckyBadgerRN]

So we are switching to a new computer system at work. Not everything will carry over and we have to do some manual entry of certain things. Allergies is one of the items that falls onto that list. We are able to print out that info from the old system so we can put in onto the new, so the information has all been verified at some point by nursing staff or physicians. Which also means at one point it was all ENTERED by someone with a license or someone who is supposed to have enough medical knowledge to do such things.

Some of the "allergies" (complete with reaction, since it's a required field):

Nitroglycerin---"it makes my ears ring"

Tetnaus shot---"my arm hurts after I get one"

E-mycin---"diarrhea"

iron supplements---"makes my BM dark"

and my favorite:

Epinephrine---"makes my heart race"

Seriously?! I can shrug and say "meh" to many things, but truly?! WHY do trained professionals DO this? Go ahead and put some of these things down and attribute the poops after an ABX to a side effect, but not an ALLERGY. Yes, side effects, intolerances and allergies are all options to choose from.

I am not even entering the epinephrine "allergies", nope, not doing it.

OK, rant over

[Anna Flaxis, BSN, RN]

...and also, there are lots of legitimate reasons why people are advised by their providers not to take certain meds. NSAIDs in people with history of GI bleeding, for instance.

Adverse reactions and intolerable side effects are legitimate reasons to avoid certain meds.

The important thing for the person to know is not to take the med, not quibble over whether it is a true allergy or not.

[KatieMI, BSN, MSN, RN]

Ugh.

Adenosine -"my heart stops". Do you prefer external cardiovertion?

Steroids: " make my blood sugar go high and I grow fat in no time"

Aspirin: "my ears ring". After eating half a box of it, you know.

Epinephrine, dopamine, dobutamine: "heart beats too fast". (I liked reaction of the doc: just give enough sedation and increase the drip as needed)

Fentanyl: "caused heart attack". Hmm, after how much of it, and with what BP?

No propofol because allergic to eggs... in childhood. Some 80 years ago.

At the same time: I have to be careful because some common components of pills made from the food stuff I am severely and legitimately allergic to, and it is virtually impossible to get pharmacists checking pill components, even if there IS a good reason for that.

[roser13, ASN, RN]

Epi makes my heart race - I'm allergic

Steroids make me feel hot - I'm allergic

ALL antibiotics give me a yeast infection - I'm allergic

ALL antibiotics give me diarrhea - I'm allergic

ACE inhibitors make me cough - I'm allergic

[Anna Flaxis, BSN, RN]

It's not the patient's lack of understanding that is irritating. It's the fact that a NURSE (or someone with the authority to take a medical history) enters these things into the legal document that is a medical record. Did you read the initial rant?

Where else are they supposed to list a med that the person has been told by their provider not to take or has had an adverse reaction or intolerance to?

[Susie2310]

The medical record my physician's practice uses has an an area for allergies, and because there is no area for sensitivities or adverse reactions all types of drug reactions are noted under allergies with notes for explanation.

[KatieMI, BSN, MSN, RN]

I saw an epi "allergy" recently as well. The reaction also stated that it caused her heart to race. (eye roll)

Also, I'm sensitive to iodine but I don't say that I have an allergy to iodine because, naturally, I would be dead then. I have a reaction to seafood, shellfish, topical iodine, and contrast dye. I've recently been told that it is something in all these things that I am truly allergic to. Any thoughts?

One cannot be allergic to iodine, as well as to any other chemical element.

Iodine (as well as other chemical elements and other small molecules ) can make chemical complexes with certain proteins in the body, usually with "sitting" IgA or IgE. It is named "haptenization" and causes subclass of allergic reactions. The most common example of it is poison ivy contact dermatitis. The good news is that hapten-related reactions almost never become more severe with time, as opposed to "classical" IgE- mediated anaphylaxis. The bad one is that treatment is the same: avoidance of affecting substances.

You need to watch your pills as well, as quite a few of them colored orange or pink contain povidone as colorant, and povidone is a potent source of iodine.

[OCNRN63, RN]

I totally get it. I have the same frustration! Some of the things people put as allergies... Really?!?!

I remember years ago when I was working in Day Surgery, we got this woman who had so many stated allergies it took three allergy bands.

I have this corollary that states that the greater the number of stated allergies, the greater the probability that the patient has a mental health history.

[Fiona59]

Cauliflower, beans, broccoli: they give me gas!

Not an allergy!

[Karou]

I love that our system allows us to specify if it is an "allergy", "side effect" or "other". It all falls under the "allergy" section but we can specify if it is actually a side effect, then state what intensity it is, and a comment section for the specific reaction. We use the "other" selection when patients have been told to avoid something by their physician (like NSAIDs for GI bleed hx).

As a nurse when asking about allergies I make sure to inform patients of the difference between a side effect and true allergy.

One thing that seems super common is "nausea" for oral abx and narcotics. I always remind them that they are supposed to take this with food... Most of them admit it was on an empty stomach. Well duh, that's going to make you nauseated!

[BuckyBadgerRN, ASN, RN]

You are completely missing the point. It's not a matter of telling someone not to "take" epinephrine. They are producing in naturally while you're discussing the stinking "allergy" with them. A "sore arm" is not a legitimate reason to avoid getting a tetorifice shot. Better to let someone be anemic than have them deal with black BM?

...and also, there are lots of legitimate reasons why people are advised by their providers not to take certain meds. NSAIDs in people with history of GI bleeding, for instance.

Adverse reactions and intolerable side effects are legitimate reasons to avoid certain meds.

The important thing for the person to know is not to take the med, not quibble over whether it is a true allergy or not.

[BuckyBadgerRN, ASN, RN]

The systems I am speaking of (and since it's my rant, that's all I am privy to), have options for listing intolerances and side effects like GI upset. This was spelled out in the original post. I beginning to wonder about your reading comprehension skills, Anna...

Where else are they supposed to list a med that the person has been told by their provider not to take or has had an adverse reaction or intolerance to?

[loriangel14, RN]

I was taught in school that an allergic reaction was either integumentary or respiratory. Anything else was just an adverse reaction or a side effect.