Allergies

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oldpro

oldpro

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Hi, I have an infection and pain

these are my allergies:

PCN
Levaquin
tetracycline
Erythromyacin
Septra
Vancomyicin
keflex
omnicef
steroids
Benadryl


Morphine
Oxycodone
Demerol
Advil
ASA
codeine
Tylox
Dilaudid

please help me!



LOL you may not this patient exists but they do, allergic to most everything by claims and looking at you to pull the "Rabbit out of the hat"

We had a similar case last night.

:laugh:

We did not believe all these allergies, But what do you do?
 
snake oil and leeches!
 
I see this pt every day with dental pain or an mrsa abscess.
clinda+ darvocet or ultram and hit the road!
 
Usually these people think an adverse effect is the same as an allergy eg, constipation means they're allergic to codeine. So ask 'em what happened when they took those drugs.

What I usually see are folks claiming an allergy to codeine so they can get Oxycontin or Oxy IR.
 
Pharmavixen said:
Usually these people think an adverse effect is the same as an allergy eg, constipation means they're allergic to codeine. So ask 'em what happened when they took those drugs.

What I usually see are folks claiming an allergy to codeine so they can get Oxycontin or Oxy IR.
Click to expand...
Yes I agree
 
oldpro said:
Hi, I have an infection and pain

these are my allergies:

PCN
Levaquin
tetracycline
Erythromyacin
Septra
Vancomyicin
keflex
omnicef
steroids
Benadryl


Morphine
Oxycodone
Demerol
Advil
ASA
codeine
Tylox
Dilaudid
Click to expand...

I don't believe that someone said they were allergic to/refused to get Dilaudid. Most patients are allergic to everything but Dilaudid.
 
Dirt said:
I don't believe that someone said they were allergic to/refused to get Dilaudid. Most patients are allergic to everything but Dilaudid.
Click to expand...

LOL OMG this has happened to me at least 5 times in the last 20 years

this past weekend It was Dilaudid in favor of Demerol

Before it was Dilaudid but not Oxycontin

You have to understand I'm saying the Patients ( Who do not understand what an Allergy is) are saying these things

In peds a Mother told me she could not wash her son ( 3 years old) because they have an allergy to H2O, yes water, there is a rare, very rare condition that people can react to water and turn red according to the Peds Doc I was with but he said it disappears over time and it would not cause death, they have to work with it.

There is a kind of common wisdom out there that these drugs are not "Natural" and cause all kind of allergies (We know them as side effects) and that Herbs are not drugs and "Natural" therefor no allergies (Side effects) and you can take any herb and get cured.

The exception is pain medicines in this messed up world of logic, once they get a favorite they latch on to it and some later give these ridiculous long lists to exclude every other drug but the favorite.

We admitted a patient with Drug reaction and chest pain, out of all the drugs we looked at on the list she had taken one was Cimitadine....... a bad over the counter drug, we told her that was not going to be continued and she became upset why?

Uh the interaction with other drugs ( some of the Cardiac she was on) including coumadin she was on, thats why.

But its over the counter!
 
Last edited:
The kid with the H2O "allergy" may have an allergic reaction to chlorine or the fluoride in the tap water. Maybe filtered water would help. In addition...how hard does the mom scrub the kid?
 
my recent favorite:
"I'm allergic to 2 mg of dilaudid IM but not 4 mg IV"....
yeah, I'll get right on that......
 
oldpro said:
Hi, I have an infection and pain

these are my allergies:

PCN
Levaquin
tetracycline
Erythromyacin
Septra
Vancomyicin
keflex
omnicef
steroids
Benadryl


Morphine
Oxycodone
Demerol
Advil
ASA
codeine
Tylox
Dilaudid

please help me!



LOL you may not this patient exists but they do, allergic to most everything by claims and looking at you to pull the "Rabbit out of the hat"

We had a similar case last night.

:laugh:

We did not believe all these allergies, But what do you do?
Click to expand...

My God. This is my pet peeve; I see this all the time. My all time favorite is "Allergic to epinephrine--makes my heart race." I've seen it more than a few times. 🙄

Maybe we should just go a la carte with these pts. and give them a menu; let them pick their abx. and pain meds of choice.
 
I have yet to see a pt. who was allergic to Dilaudid! :laugh: Toradol, yes, Dilaudid, no way!
 
fab4fan said:
I have yet to see a pt. who was allergic to Dilaudid! :laugh: Toradol, yes, Dilaudid, no way!
Click to expand...

Hey I really do agree with you. These patients are just so silly they have no idea how much they are playing with their lives in some cases.

Its like in high school there should be a mandate to teach basic health issues, one of them should be what a real allergy is.

It is not

nausea

the biggest used reason 😎
 
what about the patients whose allergie list included magnesium and that she was to have all IV antibiotics in dextrose because she was allergic to saline?
 
True. And honestly, I really don't care if someone is allergic to bees. The probability that a pt. is going to get stung by a bee while in the hospital for surgery is low, but doggone it, now I have to make up an allergy band because the pt said "I'm allergic to bee stings" and policy dictates that every allergy must be documented.

My other favorite: "I'm allergic to generic Vicodin. I need the name brand Vicodin. There's a difference." Someone just said that to me the other day, and I just said, "OK."
 
Mozart45 said:
what about the patients whose allergie list included magnesium and that she was to have all IV antibiotics in dextrose because she was allergic to saline?
Click to expand...

Honestly Saline?......... Her blood has no Na+ in it, BMP NA+ = 0? LOL

yea patients know medicine and biology best..................trust them always!
 
People can be, and often are, nuts.

A person cannot be allergic to water -- the same way they cannot be allergic to oxygen or nitrogen. What the ill-informed pediatron may have been trying to convey is aquagenic urticaria, a physical urticaria, and is not an allergic phenomenon in any stretch of the word.

Tell the people that are allergic to every pain med that they have to see an allergic for testing prior to getting any... or give them Ultracet and tell them no refills...

I hated the ER
 
oldpro said:
Honestly Saline?......... Her blood has no Na+ in it, BMP NA+ = 0? LOL

yea patients know medicine and biology best..................trust them always!
Click to expand...

You know, this is the kind of pt that would make me want to go get a can of Morton's and jiggle it in front of them, just to be evil.

But I wouldn't do that.
 
A patient presents to the ED with abdominal pain. They claim to be allergic to Vancomycin, zithromycin, every other mycin, pennicillin, Sulfa, aspirin, ibuprofen, codeine, latex, iodine and bandaids. What is the first thing you do?











Pysch Consult.
 
Dirt said:
A patient presents to the ED with abdominal pain. They claim to be allergic to Vancomycin, zithromycin, every other mycin, pennicillin, Sulfa, aspirin, ibuprofen, codeine, latex, iodine and bandaids. What is the first thing you do?











Pysch Consult.
Click to expand...

Call the chaplain? :meanie:
 
Dirt said:
A patient presents to the ED with abdominal pain. They claim to be allergic to Vancomycin, zithromycin, every other mycin, pennicillin, Sulfa, aspirin, ibuprofen, codeine, latex, iodine and bandaids. What is the first thing you do?"
Pysch Consult.
Click to expand...

just a shot in the dark here...how about a hx and physicial exam.....🙂
 
What type of pain? methadone or propoxyphene is an option. Also, what type of infection?
 
psych consult






The longer the allergy list the bigger the crazy.
 
There is an article that shows having more than 2 allergies is a huge risk for having an Axis II diagnosis. You are very validated to call a psychiatry consult to sort this mess out.

Worse.. I dont believe it is possible to be allergic to all STEROIDS.... and even Benadryl to a lesser extent. Those are what you give to kill an allergic reaction.

If the patient is really allergic to something you need to use, try desensitization, otherwise it is time to explain to them why being allergic to half the ABXs classes out there is a death sentence.

If I ever hear a patient saying he/she is allergic to dextrose or Magnesium or Iron.. I'm gonna try and not flip. What's next? Allergic to water?
 
Just simply say this:

"Just because you farted a lot last time you took an ibuprofen does not make allergic to it."
 
Faebinder said:
There is an article that shows having more than 2 allergies is a huge risk for having an Axis II diagnosis. You are very validated to call a psychiatry consult to sort this mess out.

Worse.. I dont believe it is possible to be allergic to all STEROIDS.... and even Benadryl to a lesser extent. Those are what you give to kill an allergic reaction.

If the patient is really allergic to something you need to use, try desensitization, otherwise it is time to explain to them why being allergic to half the ABXs classes out there is a death sentence.

If I ever hear a patient saying he/she is allergic to dextrose or Magnesium or Iron.. I'm gonna try and not flip. What's next? Allergic to water?
Click to expand...

If you fine the article, do me a favor and cite it. I say this all the time, and people at work call me cynical. Me, cynical? Besides, I give pts the benefit of the doubt and let them have three allergies before I call them crazy. 😉
 
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