question about infants

[june2009]

I don't have peds/nicu until next fall but I had a question in the mean time. When babies are in the NICU (or children in the PICU) They get a lot of different medications, many of which are IV. I know there is no way to know if anyone will be allergic to a med before they have received it, but if the mom or dad is allergic to a medication, are children watched more closely for an allergic reaction if they need to receive that same med? My husband is allergic to PCN, but my children have taken cephalosporins with no problems. I was thinking that the Dr. didn't even ask us if either my husband or I were allergic to anything. So does it not matter?

[classicdame, MSN, EdD]

When I worked in maternal child we always considered that THIS dose could be the one to which the child develops allergic sx. I don't know the stats regarding family history and allergies, but my experience is that you either have a reaction or you don't and it is not safe to predict. Better err on the side of caution.

[EricJRN, MSN, RN]

While some of our NICU drugs have adverse effects (like tachycardia with caffeine), true allergic reactions in neonates are very rare. However, the babies are closely monitored due to their medical conditions anyway.

As far as whether or not we would avoid a drug based on a family history of allergy, I haven't ever seen it come up. With resistance so prevalent these days, we're often already working with limited options as far as antibiotic selection.

[onyx77]

The only med allergy that I can think of that one would take parents' allergy into consideration would be with Malignant Hyperthermia. It is an allergy to anesthetic and is very severe! The only reason I know this one is because it runs in my family and we ALL have to be treated as though we have it.

But that is the only one that I am aware of. My son is allergic to Cephtin (sp?) and niether his dad or I have any med allergies. (other than the MH issue)

[justme1972]

The only med allergy that I can think of that one would take parents' allergy into consideration would be with Malignant Hyperthermia. It is an allergy to anesthetic and is very severe! The only reason I know this one is because it runs in my family and we ALL have to be treated as though we have it.

But that is the only one that I am aware of. My son is allergic to Cephtin (sp?) and niether his dad or I have any med allergies. (other than the MH issue)

Malignant Hypothermia is a KNOWN hereditary condition, so anytime someone has surgery, everyone should be assessed for a family history of this reaction.

It's 80% fatal.

My mother has a PCN allergy and I have one as well; and I think I developed an allergy to Sulfa over the years b/c I had alot of UTI's in my teens, and then one day I swelled up and I never touched them since.

[RainDreamer, BSN, RN]

I've never seen an allergic reaction to a medication in the NICU.

Allergic reactions to medications are rare in infants because of the immaturity of their immune system and immune response. Also, they haven't had the repeated exposure to the stimuli to stimulate a response.

[onyx77]

Malignant Hypothermia is a KNOWN hereditary condition, so anytime someone has surgery, everyone should be assessed for a family history of this reaction.

It's 80% fatal.

My mother has a PCN allergy and I have one as well; and I think I developed an allergy to Sulfa over the years b/c I had alot of UTI's in my teens, and then one day I swelled up and I never touched them since.

Actually it isn't something that is tested for unless there is a problem. It was first discovered in our family when we almost lost my cousin. We were all tested and told that it is possible to not have reactions all the time. It can occur at any time. And yes it is a hereditary condition. But, so is almost any allergy. If one's parents have allergies they are more likely to have allergies themselves, including allergies to meds. Which is what the OP was questioning. Malignant HyPERthermia is the only allergic reaction to meds that I am aware of that is proven to be concerning if a family member has it.

[justme1972]

Actually it isn't something that is tested for unless there is a problem. It was first discovered in our family when we almost lost my cousin. We were all tested and told that it is possible to not have reactions all the time. It can occur at any time. And yes it is a hereditary condition. But, so is almost any allergy. If one's parents have allergies they are more likely to have allergies themselves, including allergies to meds. Which is what the OP was questioning. Malignant HyPERthermia is the only allergic reaction to meds that I am aware of that is proven to be concerning if a family member has it.

I'm sorry, I was only referring to malignant hyperthermia being a known hereditary condition that needed to be assessed for before anyone has surgery, and the proper precautions need to be in place just in case.

What I stated about my mother and I having the same PCN allergy, could just as easily be coincidence as neither my brothers or sisters have any drug allergies except for me.