I'm allergic to.....(laundry list)!

[AOx1]

I just had a patient who listed about a million allergies. Among them was "oxygen" lol! When asked about this "allergy" she reported "it dries my nose." Here lately, it seems every must have multiple "allergies" many of which are just side effects. It makes me worry that those with true allergies might not have them taken as seriously. For example, a frequent flier boy's mom listed a zillion allergies, and her son actually had an anaphylactic reaction to nuts. But I fear this gets lost in all the other "allergies" he has. Anyone else worry about this?

[bewitched]

My father stopped taking his Altace because "it made him cough". I live 250 miles away and he told me this over the phone. I freaked. I told him "You go and take one right now. NOW, NOW, NOW! I wouldn't get off the phone until he went and took one. Then I told him to go see his doctor and get his med changed. He told me; "the pharmacist told me the cough was from the Altace". Knowing my father, I asked "And WHAT ELSE did she tell you??" He then said "she told me to go see the doctor and get it changed. I decided to stop taking it because my blood pressure was OK" Yes Dad - that was because the medication was WORKING! (his BP was 220/110 when first diagnoses with hypetension). Next day he went to MD and got a new med. Mom thought I was funny until I pointed out that he could have had a stroke by stopping his med without MD approval.

This drives me up a WALL, my fiancee's mom does this all the time! Or slowly "backs off" on a medication she feels like she doesn't need... UGH.

:spam:

[NeoPediRN]

I wonder if it was the same lady that had an allergy to epinephrine, as it made her heart race.

LOL. Not quite the same thing, but I list pseudoephedrine as an allergy because I was recently prescribed Allegra-D and it sped my heart rate up to 160 at rest and gave me some serious ectopy. (I should probably add I have congenital heart disease). Can't imagine what it must be like to get epinephrine!

[Nascar nurse, ASN, RN]

Well here's a strange allergy for ya all.

I am allergic to Metamucil & have never taken a dose in my life. After years of administering this in long term care, if I open a jar of metamucil & just scoop out a dose, I start sneezing, coughing, tearing to the point of looking like I am bawling my eyes out and eventually my eyes swell nearly shut. Got so bad, they had to rearrange all the metamucil dosages off of my usual shift.

This happens no matter how carefully I try to scoop without causing a "powder dust cloud". Our pharmacist told me to never attempt to take an oral dose myself.

[Indus]

I'm not allergic to any meds, but tell whomever, that I'm sensitive to Erythromycin...with my IBS, in the past, it plays havoc with my gut for 1-2 months!

I do have an allergy to curry though. After eating curry for the first time, my nose, lips, and tongue swelled up! I actually don't even like the smell of it anymore....it starts to make me nauseous...not sure if the nausea is in my 'head' or if it's the start of an allergic response.

The thing is, curry is made of several different ingredients, and can be different from one restaurant to the next...

[JustBeachyNurse, LPN]

I had a friend who was severely allergic to sulfates. Couldn't even drink certain wines. She kept a supply of preservative free epinephrine in her fridge as the EpiPen has a sulfate preservative. She even had allergic reactions to the sulfate in morphine. She couldn't have certain forms of Benadryl because of sulfate preservatives. Apparently there is a preservative free/sulfate free version (usually single dose).

To this day I'm not sure how her doc narrowed her anaphylaxis down to the sulfate, though I suspect it was when he used a regular multi-dose vial of epi & she got worse, but had a non-sulfate preservative version that was able to stop the reaction. (since technically you can't be allergic to epinephrine I'm told)

[nursel56]

I've often thought it might be helpful to list two categories per pt chart:

1. ALLERGIES: true: medications/foods to which one reacts with hives, "swelling," rash, itching, anaphylactoid reactions, etc

2. SENSITIVITIES (another word might be more descriptive/accurate): medications/foods to which one reacts with cough (d/t ACEIs, etc), GI upset, hypotension (from certain antihypertensives ), etc.

Just a thought.

I think this is the most sensible route to take as opposed to "an allergy is what the patient says it is". They aren't the same, and sometimes it actually does matter! If there is confusion about whether the person taking the patient history is calling sensitivities "allergies" it causes problems down the line especially with antibiotics. Hives and tongue swelling must be differentiated from "it gave me an upset stomach for a few hours".

[Ruby Vee, BSN]

oh, i had a lady with a lasix allergy. it made her pee too much.

i hear that one a lot. and digoxin slows their heart rate. amazingly one of my patients was allergic to ambien. it made him sleepy.

[AgentBeast, MSN, RN]

I'm allergic to alcoholic beverages. The symptoms range from frequent urination to slurred speech, poor coordination, and memory lapses.

[wtbcrna, MSN, DNP, CRNA]

Considering that allergic reactions can run the gamut from n/v/d to anaphylaxis, how do you determine what reaction is IgE mediated and what is a side effect from talking to a patient?

Most of it is an educated guess, but if a patient is taking a drug that is known to have high level of N/V associated with it and they have taken other medications in that same class then you can be pretty sure that they aren't allergic to that particular drug.

Somethings are easy to rule out though: Nitroglycerin/HA, ASA/Motrin/upset stomach etc.

[raianne]

There was a lady in the ER a few years ago who was listed as being allergic to "hot showers"!!

[wtbcrna, MSN, DNP, CRNA]

The bottom line is if a patient doesn't want any particular medication, all they have to do is say no. You can't force them.

I totally agree if a patient has a request or legitimate reason not get a medication then I don't give it unless it will cause serious harm otherwise.

On the flip side as a provider I can refuse any elective case that I think can't be done safely due to a patient's request.

[Spritenurse1210, BSN, RN]

I understand true allergies. I just hate it when people say they are "allergic" to medications that they just don't want. My personal favorite, being allergic to tyelenol because it makes them "throw up instantly" and get an upset stomach. The only thing that will cure this is Morphine. Go figure.