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Drug claims and allergies seem to be the most important parts of a medical record, a medical record, a edical record - we all see mistakes too often.
I think that one
cannot introduce an allergy without describing the reaction. Because without
this information, the list becomes completely useless.
I recently reached
out to a patient who urgently needed a CT angiogram. The allergy list says “all
contrast media”, which is not even “structured input” and is therefore not
recognized by the computer if my EMR (Greenway again!) Were smart enough to
check for allergies when I order a computed tomography.
After much
research, "allergy" turned out to be a multitude of unspecific
chronic symptoms in this case after several myelograms of the lumbar CT in a
short time many years ago.
Some people claim
they are allergic to penicillin because "it never helps". Others list
iprofloxacin or sulfa antibiotics as others experience mild nausea or post-pien
fatigue after taking the first dose of an SSRI such as fluoxetine.
Some of the symptoms listed as allergies are little known. For example, morphine causes itching in many patients, even skin symptoms such as redness and sweating, but it is usually not a histamine-mediated symptom or allergy. Other opioids like hydromorphone have a lower risk of itching.
Achelle of
inhibitors is not a real allergy, but we often put it on our allergy lists. Tag
with this side effect can be safely translated into locators of angiotensin
receptors, ARBs.
Angioedema caused
by ACE inhibitors is a severe allergic reaction with a significant risk of
cross-allergies, including ARBs. It is therefore important to distinguish
between the two in our allergy lists.
Medicines and
allergic anamnesis are among the few for which specialists contact us. For example,
they often ignore and repeat our tests. A good allergy history is something we
can and should collect for everyone
The big problem is
that patients often don't remember the details of their allergy, so when we
hear about them, it is imperative that we carefully record new reactions
My personal trick
on new patients who have long lists of reported allergies is to ask, “? You
would have died rapidly from one of those drugs that I consider allergies.
”This is the first step in actually assessing your allergy.
Another list that we could use better is the PROBLEM LIST. Since we switched to electronics, it has grown and is much less useful than it used to be. Just reread a post that wrote about it eleven years ago.