Medication allergies can get out of hand. Most often they are not truly allergies at all. The thing that really amazes me about patients with this many medication allergies is that they have tried this many different medications to begin with!
Some important points to remember about medication allergy lists, feel free to leave some comments on other considerations:
1. Ask patients what the reported “allergy” is. As I mentioned above, most often it is an adverse reaction, not a true allergy.
2. After you ask the patients (sometimes they don’t remember especially in cases like above) about their medication allergies/intolerances, take the time to document the outcome. Cough from an ACE inhibitor or was it angioedema, or maybe worsening renal function? Sometimes intolerances can be just as important as allergies.
3. Communicate with other healthcare professionals. I’ve seen many cases where a clinic, pharmacy, home care, LTC etc. doesn’t report the allergy or intolerance to other institutions that also take care of that patient. Critical checks can be missed in the future due to poor documentation and notification.
4. Try to encourage and engage patients in their own care. Make sure they have a list of their medication allergies in the event that #3 doesn’t happen. Also tell them to write down what happened!
5. Don’t ignore “big” allergy lists like this. It’s easy to have a lax attitude and assume that all these allergies are intolerances. It isn’t a good idea. What if one of these was severe? Are you willing to take that chance?
New to the blog? Please check out the 30 medication mistakes I see in my practice as a clinical pharmacist. It’s FREE of course!
Eric Christianson, PharmD, BCPS, CGP