Table 2: Classification of Immune Mediated Adverse Drug Reactions . Adapted from Adkinson NF . Drug Allergy. In Middleton's Allergy: Principles and Practice, 6 th edition. New York : Mosby 2003. p. 1679-94, table 92-3.

 

Gel-Coombs

Classification

Mechanism

Examples of Adverse Penicillin Reactions

Other medication examples

I

Anaphylactic (IgE-mediated injury)

Acute anaphylaxis Urticaria

 

II

C'-dependent cytolysis (IgG/IgM)

Hemolytic anemias

Quinidine, alpha-methyldopa



Thrombocytopenia

 



Interstitial nephritis

NSAIDs

III

Immune complex damage

Serum sickness

Murine monoclonal antibodies



Drug fever

 



Some cutaneous eruptions and vasculitis

 

IV

“Delayed” or cellular hypersensitivity

Contact dermatitis

Topical drugs



Morbilliform eruptions

 

C, Complement.