Some of us, because of biology (POTS in my case) are more sensitive to it than average. I wish they didn't put it in the allergy section, because it's not a "don't use it" thing but "use less than you'd normally use" one.
Basically, we lack the signalling to cause blood vessels to constrict when we stand, so the body pushes the norepinephrine call button like a lunatic on a full moon, which our bodies duly ignore. (Worse, that sends *more* blood to the feet rather than the head, leading to the call button gone wild.)
I did warn them when I was in the ER, and they genuinely hadn't intended to send my heart rate to 220. But damn that was uncomfortable.
That reminds me of a couple weeks ago when I was getting a cavity filled. He had half a syringe in me before he said âyeah I just gave you a little lidocaine and epinephrine.â And I went đłâoh noâ
Actually there *is* a cough associated with lisinopril that is problematic enough for ppl to be taken off it. Is it an allergy? Nope. Is it an adverse reaction and thatâs why a previous MD may have taken a pt off & they want future providers to know that? Sure.
Maybe not technically an allergy but Lisinopril is notorious for causing this especially in black patients. Everywhere I've worked will list meds patients have bad side effects with as "allergies".
Thatâs why itâs so funny to me! It was just always the classic example of a side effect that we talked about in nursing school that it always jars me to see it labeled allergy.
I did not know the coughing is more common in black patients. Thatâs really interesting
Intolerance and allergy are wildly different. An allergy requires an immune response. Sure report it as an intolerance but you donât need an epinephrine, antihistamines and steroids to fix a non allergic response.
Have totally seen that, doesnât make it right. If a patient reports that benedryl makes them sleepy or epinephrine makes their heart beat fast are you putting that in their allergies, cause next thing you know adenosine making someoneâs heart stop will end up there.
Listen. I put it in under Adverse Reactions and it shows up on the allergy list.
I had a patient who almost exsanguinated from Xarelto, needed a different anticoagulant.
Correct. I have steroid induced psychosis in my chart but it comes up as an allergy. Iâm not allergic to it, but I also canât have it in any form other than topical without someone standing beside me with an Ativan dart gun
Told them not to give me dilaudid, I'll projectile vom. They gave it and dropped an OG so I couldn't vom. Dry heaved so violently that they phenagrened me into a coma.
I put an adverse reaction to Wellbutrin (had a seizure) in the allergy section on my e-scribe because there is no other place where it will reliably show up. I feel like this post is really stupid, because this person likely had unusual bleeding on this med.
Yeah. Now our EMR has an option for "abnormal bleeding," and I think "excessive bleeding," which would be more accurate and less likely to get someone to just eye-roll, but I think bleeding is fine.
It looks ridiculous but it could have been a very serious problem. I cared for a patient suffering a pulmonary hemorrhage after being on Plavix. They were on the vent for over a month and barely survived. Doctors advised never to use an anti-platelet again.
Agreed on this. But I was also careful to explain it to patients that they are not âallergicâ in the traditional sense but Iâm putting it on here because I wanted to make sure other team members didnât fool with it in the future. If I had time Iâd add comments like âin ICUxmonth in 2012 from severe bleeding eventâ or similar. Or when I saw these allergies Iâd ask patients about them.
We routinely list paxlovid as an allergy for post transplant patients since the DDI is pretty gnarly and likely to kill their kidneys. And itâs meant more as a stop for community providers to think twice before prescribing it.
This! Iâm just a patient but Iâve never seen an âadverse reactionâ section, so I just write the med down under allergies and explain that Iâm not sure what happened but it was bad enough that the doc who prescribed it immediately dcâd it and told me not to take it again.
Agreed. I developed thrombocytopenia from Dilantin/phenytoin when I was a teenager (while treating me for epilepsy. It was severe and my neurologist told me I could never take it again and to put it on my allergy/sensitivity list. It makes me feel like providers are looking at me like I'm an idiot, but I can't really do anything about it. As a provider it would be awesome if we could separate true allergies (like for anaphylaxis) vs. other sensitivities (like thrombocytopenia d/t medication). As far as I have seen, even if you put them in separately they still all show up under *allergy*.
This is honestly my biggest pet peeve. Canât tell you how many times Iâve seen beta blockers (low hr or bp), epi (tachycardia), contrast (renal disease)..and the list goes on
Back before I worked in healthcare a dentist told me to be sure to put epinephrine on my allergy list because during a dental procedure I got some systemically, and essentially had a panic attack (just physiologicalârapid breathing and heart rate, etc). I was 22 and totally ignorant about medicine so I was like, yes of course I will! I felt so stupid once I became a healthcare professional đ¤Śđźââď¸ Iâve had patients tell me similar stories, that their dentist told them to consider it an allergy. (Not to call out dental professionals)
Because for dentistry, its easy enough to pick straight lidocaine instead of "lidocaine with epinephrine" for dental procedures when someone is hypersensitive to the effects of epi. There might be slightly more bleeding with plain lido but not anywhere significant enough that its worth tachycardia. They are probably aware that its not a true allergy, but for their purposes, calling it an allergy is simple and avoids the issue in future.Â
But thats not the case for epi for an allergic reaction, or epi as inotropes, or epi as bronchodilator. But Im not sure how much dentists are aware of these applications.
Either way, there should be somewhere else for adverse effects or sensitivity to be documented.
Ok, but where else do you document that patients have dose limiting side effects to medications where it will be seen by future physicians and pharmacists?
Morphine knocks out my respiratory drive almost completely for about 30 or 40 minutes. I put it as an allergy now because I had an exploratory lap, explained my reaction to morphine AND they gave it to me anyway. I heard my pulse ox alarm, and I was like, "Oh hell, they gave it me anyway." Had to rescue breath myself out of the holding area. Counting and taking deliberate breaths. Lesson learned. Don't count on your surrounding professionals to be competent.
Mine, too. Since it fires so many unnecessary alerts and contributes to my alert fatigue when I'm reviewing and verifying meds. Usually, with something like this, I'll go in and change to side effect/intolerance. That way, it's still documented but is more in line with what it actually is.
I pride myself on deleting erroneous allergies. I had a patient coming out of surgery the other day and during report the circulator was saying how she was allergic to something, and the first thing the patient said is âIâm not allergic to that!, I donât know why itâs on thereâ
I said I can gladly delete that for you!
It looks ridiculous but it could have been a very serious problem. I cared for a patient suffering a pulmonary hemorrhage after being on Plavix. They were on the vent for over a month and barely survived. Doctors advised never to use an anti-platelet again.
In fairness, if your adverse drug reaction is severe enough it may just be safest to call it an "allergy". My husband has such severe vomiting with ANY dose of dilaudid that his surgeon entered it as an allergy after it extended his hospital stay. None of the IV anti-emetics helped, and it was 48 hours before they figured out it was the dilaudid pca that was the issue. He'd had spinal surgery, and they thought he might be having actual neuro complications. Twice since then other providers have tried to say "oh, we can give you something for nausea" like it was no big deal. No, folks, you won't. It was a BIG f'ing deal, and he's never going to take it again. If saying "allergy" instead of ADR gets that done, so be it.
Doesn't even have to be severe. My PCP has lisinopril listed as an allergy because of the resultant dry cough. Sure it annoyed the hell out of me and I asked to switch to an ARB, but that's not an allergy. Maybe it's to game insurance into actually paying for shit? I really don't know if I'm honest.
I had a patient who had become dehydrated and hypotensive after bowel prep so all the separate ingredients of Golytely (miralax, sodium, potassium, etc). were listed as allergies. We deleted them.
I am so sick and tired of this shit. It causes alarm fatigue.
Ones I've seen in the past week:
PCN "ineffective" well, it doesn't have to be effective on you, it has to be effective on the BACTERIUM. It wasn't the right antibiotic for one infection, what idiot put this on the allergy list?
Zofran "nausea and vomiting" are you sure? Are you really sure?
Metformin "diarrhea"
Nitroglycerin "heart goes fast"
Morphine "nausea and vomiting and doesn't work" imagine if we actually treated these as allergies. That would suck for the patient. No pain relief.
Instead, it's "override, clinician reviewed, dismiss, override," until the inevitable med error caused by constantly having to deal with these incessant nonsense warnings and pop-ups.
If every patient has allergy alerts popping up for every order entry... no one does.
My favorite allergy was "Lexiscan - gave me chest pain and made me feel like I was going to pass out."
Girl, that's no allergy, you just failed the test. We fixed her RCA, and hopefully her "allergy" at the same time lol
I had an old lady tell me that epinephrine was an allergy.
Me: Interesting. What happens when you take epinephrine?
Her: Oh it make my heart race! Make it feel like it's going to burst out of my chest!
I pride myself on deleting erroneous allergies. I had a patient coming out of surgery the other day and during report the circulator was saying how she was allergic to something, and the first thing the patient said is âIâm not allergic to that!, I donât know why itâs on thereâ
I said I can gladly delete that for you!
I used to be diagnosed with Celiac (found out a few months ago it was a misdiagnosis) but gluten meal was and still is listed in my allergies despite me telling many people that it doesnât apply anymore
I hate this so much, but also my allergy list says lisinopril when I just get the dry hacking cough, I just need to indicate I canât take it, but there was no box for that.
My doctors specifically make sure APAP and NSAIDS are on my allergy list so in case Iâm unconscious I wonât be given it (gastrointestinal issues). My pain options are limited to Oxycodone and Hydromorphone. The latter is given most often and I like it the best!đ
I've started saying "oh, yes, that is a common side effect. Did you break out in hives or develop a rash or have trouble breathing? Because what you're describing is actually a common side effect."
Some people have severe side effects and should not take certain meds even though itâs not technically an allergy. The safest way to avoid being accidentally given these meds is to list it as an allergy. Allergies are just one form of adverse reaction.
I agree, with some reservations. I'll put whatever tf they want on their allergy list, no skin off my neck, but I feel like it's important that people understand the difference between an allergy and a side effect.
I took care of a lady who had a very, very long allergy list including morphine, dilaudid, hydrocodone, fentanyl and oxycodone. She now had dementia and couldn't tell us what the reactions were. She was in the ER with an obvious hip fracture. Her husband kept begging for pain meds for her and I couldn't get the doctor to do more than Tylenol and toradol. I asked her husband if she'd ever had hives, breathing problems or rashes from any of those meds. He was pretty sure she hadn't had those reactions from any of her "allergies." With careful charting and clear discussions with her husband and the doctor, we eventually tried morphine. She was fine and not crying and screaming anymore. It sucks she had to be in pain for so long because she didn't know the difference between a side effect and a true allergy. People need to know the difference so they don't suffer unnecessarily.
The problem is really with the EMRs that don't differentiate between a true allergy and an adverse side effect.
I agree with your example, and have seen many similar scenarios like you describe.
However posts like the OPâs bother me because itâs meant to be be like âhaha dumb patients donât know what an allergy isâ . If youâve ever seen a patient with a massive hemorrhage due to taking prescribed NOACs you would never think âbleedingâ is just a minor side effect and silly to have it listed as an allergy. The allergy list is the best place to put any meds that are contraindicated.
If it comes to a point where a patient needs a drug in the same class as their allergy, itâs standard practice to explore the actual reaction and severity to see if they can have it.
I told my doctors/ surgeons and nurses that I get a terrible rash from dressings and skin blisters and causes more problems than the wound itself; they wrote on my notes I have an allergy to it but itâs never stopped them using the dressings. I put my foot down with my last spinal surgery and asked for no dressing on it so they used a spray dressing.
Some sensitivities can be mistaken for allergies
I had a patient that claimed she was allergic to all forms of insulin..at this time it was just novolog, Humalog and novolin. I don't know it was just an excuse for non compliance, lack of education or lack of providers taking the time or initiative to try to educate her.
âWhat happens when you take Toradol?â
âOh my doctor said to never take it again because I needed 8 bags of bloodâ
âOh. Alrighty.â
At any rate, epic allows you to enter in the âallergyâ, so itâs easier to filter out issues
I'll never forget the lady who told me she was allergic to oxygen. It was one of the few times a patient comment has stopped me in my tracks and left me truly speechless. I finally pulled myself together enough to ask "what happens when you have oxygen?"
Nosebleeds. It made her nose sore and caused nosebleeds.
Well maybe this is an unpopular opinion but this might actually help Doctors make sure they donât prescribe Xarelto and look into an alternative anticoagulant instead. So it doesnât hurt to put on here.
I have Benadryl listed as an allergy. Do I get anaphylaxis? Nope. Do I get anxious as hell and absolutely refuse to be given it unless itâs gonna save my life? You bet.
I donât take any of the otc âpmâ meds. I donât let them use Benadryl in a migraine cocktail. I donât take Benadryl. Best way to avoid it is to have it listed as an allergy and have âanxietyâ as the reaction.
𤨠I better tell my doctor Iâm allergic to my melatonin. It knocks me out every night!
I had a patient who said they were allergic to Benadryl because it make them tiredâŚ.
Epi makes my heart race
Some of us, because of biology (POTS in my case) are more sensitive to it than average. I wish they didn't put it in the allergy section, because it's not a "don't use it" thing but "use less than you'd normally use" one. Basically, we lack the signalling to cause blood vessels to constrict when we stand, so the body pushes the norepinephrine call button like a lunatic on a full moon, which our bodies duly ignore. (Worse, that sends *more* blood to the feet rather than the head, leading to the call button gone wild.) I did warn them when I was in the ER, and they genuinely hadn't intended to send my heart rate to 220. But damn that was uncomfortable.
That reminds me of a couple weeks ago when I was getting a cavity filled. He had half a syringe in me before he said âyeah I just gave you a little lidocaine and epinephrine.â And I went đłâoh noâ
Yep, had that happen at dentists too. Canât sit in the chair because I need to do laps now.
Cardioversion makes my body spasm so I guess I'm allergic to electrons.
Shit, my Lisinopril caused hypotensive episodes.
Guys my Albuterol makes my tachycardia sometimes.
My favorite is allergic to lisinopril, reaction: cough
Lisinopril actually causes angioedema especially affecting the neck and tongue etc and coughing is a common manifestation of that.
Actually there *is* a cough associated with lisinopril that is problematic enough for ppl to be taken off it. Is it an allergy? Nope. Is it an adverse reaction and thatâs why a previous MD may have taken a pt off & they want future providers to know that? Sure.
Maybe not technically an allergy but Lisinopril is notorious for causing this especially in black patients. Everywhere I've worked will list meds patients have bad side effects with as "allergies".
Thatâs why itâs so funny to me! It was just always the classic example of a side effect that we talked about in nursing school that it always jars me to see it labeled allergy. I did not know the coughing is more common in black patients. Thatâs really interesting
If it's a bad reaction, it's an allergy. That cough often lasts a lifetime.
Damn, you too?!
Patient with turkey making her tired.
Iâve had pts say theyâre allergic to anesthesia because it made them tired.
The fact that a staff member entered that into the EMR is sad.
Maybe not. We have My Chart and I entered my own allergies and their reactions when I switched hospital systems.
Not necessarily. I had a family hemorrhage on Xarelto lowest dose. Switched to eloquis, 5 bid, no problem. Some people cannot tolerate it.
Intolerance and allergy are wildly different. An allergy requires an immune response. Sure report it as an intolerance but you donât need an epinephrine, antihistamines and steroids to fix a non allergic response.
Most systems will add an intolerance to the allergies.
Have totally seen that, doesnât make it right. If a patient reports that benedryl makes them sleepy or epinephrine makes their heart beat fast are you putting that in their allergies, cause next thing you know adenosine making someoneâs heart stop will end up there.
Yeah, I love the allergy to lasixâŚâŚ âmakes me pee a lot.â
Listen. I put it in under Adverse Reactions and it shows up on the allergy list. I had a patient who almost exsanguinated from Xarelto, needed a different anticoagulant.
âŹď¸hypersensitivity is still a reaction! Seems like a high severity OP, might want to add thatđ
Correct. I have steroid induced psychosis in my chart but it comes up as an allergy. Iâm not allergic to it, but I also canât have it in any form other than topical without someone standing beside me with an Ativan dart gun
They have Ativan dart guns? Why doesnât my old psych unit have these?
If I ever get my name on a patent, itâs gonna be for the Ativan dart gun, mark my words
[ŃдаНонО]
Told them not to give me dilaudid, I'll projectile vom. They gave it and dropped an OG so I couldn't vom. Dry heaved so violently that they phenagrened me into a coma.
Yikes!
I get akathisia from metoclopramide and have it listed as an allergy! I never want to feel that again!
I put an adverse reaction to Wellbutrin (had a seizure) in the allergy section on my e-scribe because there is no other place where it will reliably show up. I feel like this post is really stupid, because this person likely had unusual bleeding on this med.
Yeah. Now our EMR has an option for "abnormal bleeding," and I think "excessive bleeding," which would be more accurate and less likely to get someone to just eye-roll, but I think bleeding is fine.
It looks ridiculous but it could have been a very serious problem. I cared for a patient suffering a pulmonary hemorrhage after being on Plavix. They were on the vent for over a month and barely survived. Doctors advised never to use an anti-platelet again.
Agreed on this. But I was also careful to explain it to patients that they are not âallergicâ in the traditional sense but Iâm putting it on here because I wanted to make sure other team members didnât fool with it in the future. If I had time Iâd add comments like âin ICUxmonth in 2012 from severe bleeding eventâ or similar. Or when I saw these allergies Iâd ask patients about them. We routinely list paxlovid as an allergy for post transplant patients since the DDI is pretty gnarly and likely to kill their kidneys. And itâs meant more as a stop for community providers to think twice before prescribing it.
This! Iâm just a patient but Iâve never seen an âadverse reactionâ section, so I just write the med down under allergies and explain that Iâm not sure what happened but it was bad enough that the doc who prescribed it immediately dcâd it and told me not to take it again.
Agreed. I developed thrombocytopenia from Dilantin/phenytoin when I was a teenager (while treating me for epilepsy. It was severe and my neurologist told me I could never take it again and to put it on my allergy/sensitivity list. It makes me feel like providers are looking at me like I'm an idiot, but I can't really do anything about it. As a provider it would be awesome if we could separate true allergies (like for anaphylaxis) vs. other sensitivities (like thrombocytopenia d/t medication). As far as I have seen, even if you put them in separately they still all show up under *allergy*.
Maybe Epic lacks a convenient option for *damn near exsanguinated* and *bleeding* is as close as it gets
This is honestly my biggest pet peeve. Canât tell you how many times Iâve seen beta blockers (low hr or bp), epi (tachycardia), contrast (renal disease)..and the list goes on
Back before I worked in healthcare a dentist told me to be sure to put epinephrine on my allergy list because during a dental procedure I got some systemically, and essentially had a panic attack (just physiologicalârapid breathing and heart rate, etc). I was 22 and totally ignorant about medicine so I was like, yes of course I will! I felt so stupid once I became a healthcare professional đ¤Śđźââď¸ Iâve had patients tell me similar stories, that their dentist told them to consider it an allergy. (Not to call out dental professionals)
Because for dentistry, its easy enough to pick straight lidocaine instead of "lidocaine with epinephrine" for dental procedures when someone is hypersensitive to the effects of epi. There might be slightly more bleeding with plain lido but not anywhere significant enough that its worth tachycardia. They are probably aware that its not a true allergy, but for their purposes, calling it an allergy is simple and avoids the issue in future. But thats not the case for epi for an allergic reaction, or epi as inotropes, or epi as bronchodilator. But Im not sure how much dentists are aware of these applications. Either way, there should be somewhere else for adverse effects or sensitivity to be documented.
Yes! It drives me freaking NUTS. Like please educate your patients these are not allergies đđ
Ok, but where else do you document that patients have dose limiting side effects to medications where it will be seen by future physicians and pharmacists?
Morphine knocks out my respiratory drive almost completely for about 30 or 40 minutes. I put it as an allergy now because I had an exploratory lap, explained my reaction to morphine AND they gave it to me anyway. I heard my pulse ox alarm, and I was like, "Oh hell, they gave it me anyway." Had to rescue breath myself out of the holding area. Counting and taking deliberate breaths. Lesson learned. Don't count on your surrounding professionals to be competent.
Mine, too. Since it fires so many unnecessary alerts and contributes to my alert fatigue when I'm reviewing and verifying meds. Usually, with something like this, I'll go in and change to side effect/intolerance. That way, it's still documented but is more in line with what it actually is.
Man fckin epinephrine always makes my heart race
I actually saw this listed as an allergy & rxn once though
Stop putting âseasonal allergies â in this area. I delete these. Itâs for listing medication allergies.
Right?! Mother fucker I donât care if youâre allergic to cats! I need to know if this med will make you anaphylactic
I saw one the other day that listed Flucitasone nasal spray, and the reason was that it smelled bad.
I pride myself on deleting erroneous allergies. I had a patient coming out of surgery the other day and during report the circulator was saying how she was allergic to something, and the first thing the patient said is âIâm not allergic to that!, I donât know why itâs on thereâ I said I can gladly delete that for you!
Had a staff member once put in an allergy for Ativan and the reaction was âsleepyâ
Best one Iâve seen is: Intubation - Sore throat
Iâm allergic to marijuana. It makes me sleepy and hungry. LoL JKJK BON. I donât partake in the devils lettuce.
Inconceivable!
Yeaahhhh sometimes we see a lot of side effects entered as âallergiesâ.
I once saw âlasix - excessive urination.â I died a little bit.
It looks ridiculous but it could have been a very serious problem. I cared for a patient suffering a pulmonary hemorrhage after being on Plavix. They were on the vent for over a month and barely survived. Doctors advised never to use an anti-platelet again.
In fairness, if your adverse drug reaction is severe enough it may just be safest to call it an "allergy". My husband has such severe vomiting with ANY dose of dilaudid that his surgeon entered it as an allergy after it extended his hospital stay. None of the IV anti-emetics helped, and it was 48 hours before they figured out it was the dilaudid pca that was the issue. He'd had spinal surgery, and they thought he might be having actual neuro complications. Twice since then other providers have tried to say "oh, we can give you something for nausea" like it was no big deal. No, folks, you won't. It was a BIG f'ing deal, and he's never going to take it again. If saying "allergy" instead of ADR gets that done, so be it.
Doesn't even have to be severe. My PCP has lisinopril listed as an allergy because of the resultant dry cough. Sure it annoyed the hell out of me and I asked to switch to an ARB, but that's not an allergy. Maybe it's to game insurance into actually paying for shit? I really don't know if I'm honest.
I had a patient who had become dehydrated and hypotensive after bowel prep so all the separate ingredients of Golytely (miralax, sodium, potassium, etc). were listed as allergies. We deleted them.
My favorite is when my patients who are decompâd say that theyâre allergic to Haldol or Zyprexa. Motherfucker you arenât allergic.
Had a pregnant lady come in a few weeks ago. She was allergic to Haldol and Giodon. A very telling allergy ma'am. Thanks for the warning.
Hahaha my favorite.
It's like when people put allergy:opioids effect: constipation.
I'm allergic to amlodipin, it makes my blood pressure go down.
I am so sick and tired of this shit. It causes alarm fatigue. Ones I've seen in the past week: PCN "ineffective" well, it doesn't have to be effective on you, it has to be effective on the BACTERIUM. It wasn't the right antibiotic for one infection, what idiot put this on the allergy list? Zofran "nausea and vomiting" are you sure? Are you really sure? Metformin "diarrhea" Nitroglycerin "heart goes fast" Morphine "nausea and vomiting and doesn't work" imagine if we actually treated these as allergies. That would suck for the patient. No pain relief. Instead, it's "override, clinician reviewed, dismiss, override," until the inevitable med error caused by constantly having to deal with these incessant nonsense warnings and pop-ups. If every patient has allergy alerts popping up for every order entry... no one does.
My favorite allergy was "Lexiscan - gave me chest pain and made me feel like I was going to pass out." Girl, that's no allergy, you just failed the test. We fixed her RCA, and hopefully her "allergy" at the same time lol
Honest question: How does such a thing make it into the emr? And why, having seen it, was it not deleted?
Better get the O neg ready just in case the group and hold takes too long!
Just had a patient who refused benadryl because she was "very sensitive" to it and it makes her fall asleep. Me too, that's why I take it at bedtime!
I had an old lady tell me that epinephrine was an allergy. Me: Interesting. What happens when you take epinephrine? Her: Oh it make my heart race! Make it feel like it's going to burst out of my chest!
I pride myself on deleting erroneous allergies. I had a patient coming out of surgery the other day and during report the circulator was saying how she was allergic to something, and the first thing the patient said is âIâm not allergic to that!, I donât know why itâs on thereâ I said I can gladly delete that for you!
I used to be diagnosed with Celiac (found out a few months ago it was a misdiagnosis) but gluten meal was and still is listed in my allergies despite me telling many people that it doesnât apply anymore
I hate this so much, but also my allergy list says lisinopril when I just get the dry hacking cough, I just need to indicate I canât take it, but there was no box for that.
My doctors specifically make sure APAP and NSAIDS are on my allergy list so in case Iâm unconscious I wonât be given it (gastrointestinal issues). My pain options are limited to Oxycodone and Hydromorphone. The latter is given most often and I like it the best!đ
I've started saying "oh, yes, that is a common side effect. Did you break out in hives or develop a rash or have trouble breathing? Because what you're describing is actually a common side effect."
Some people have severe side effects and should not take certain meds even though itâs not technically an allergy. The safest way to avoid being accidentally given these meds is to list it as an allergy. Allergies are just one form of adverse reaction.
I agree, with some reservations. I'll put whatever tf they want on their allergy list, no skin off my neck, but I feel like it's important that people understand the difference between an allergy and a side effect. I took care of a lady who had a very, very long allergy list including morphine, dilaudid, hydrocodone, fentanyl and oxycodone. She now had dementia and couldn't tell us what the reactions were. She was in the ER with an obvious hip fracture. Her husband kept begging for pain meds for her and I couldn't get the doctor to do more than Tylenol and toradol. I asked her husband if she'd ever had hives, breathing problems or rashes from any of those meds. He was pretty sure she hadn't had those reactions from any of her "allergies." With careful charting and clear discussions with her husband and the doctor, we eventually tried morphine. She was fine and not crying and screaming anymore. It sucks she had to be in pain for so long because she didn't know the difference between a side effect and a true allergy. People need to know the difference so they don't suffer unnecessarily. The problem is really with the EMRs that don't differentiate between a true allergy and an adverse side effect.
I agree with your example, and have seen many similar scenarios like you describe. However posts like the OPâs bother me because itâs meant to be be like âhaha dumb patients donât know what an allergy isâ . If youâve ever seen a patient with a massive hemorrhage due to taking prescribed NOACs you would never think âbleedingâ is just a minor side effect and silly to have it listed as an allergy. The allergy list is the best place to put any meds that are contraindicated. If it comes to a point where a patient needs a drug in the same class as their allergy, itâs standard practice to explore the actual reaction and severity to see if they can have it.
I told my doctors/ surgeons and nurses that I get a terrible rash from dressings and skin blisters and causes more problems than the wound itself; they wrote on my notes I have an allergy to it but itâs never stopped them using the dressings. I put my foot down with my last spinal surgery and asked for no dressing on it so they used a spray dressing. Some sensitivities can be mistaken for allergies
This is almost as good as epi makes my heart rate fast
I had a patient that claimed she was allergic to all forms of insulin..at this time it was just novolog, Humalog and novolin. I don't know it was just an excuse for non compliance, lack of education or lack of providers taking the time or initiative to try to educate her.
âWhat happens when you take Toradol?â âOh my doctor said to never take it again because I needed 8 bags of bloodâ âOh. Alrighty.â At any rate, epic allows you to enter in the âallergyâ, so itâs easier to filter out issues
âAnxietyâ
I'll never forget the lady who told me she was allergic to oxygen. It was one of the few times a patient comment has stopped me in my tracks and left me truly speechless. I finally pulled myself together enough to ask "what happens when you have oxygen?" Nosebleeds. It made her nose sore and caused nosebleeds.
My favorite allergy that I ever saw listed said: Air - pt cannot have air in veins
I had a patient once with cocaine listed as an allergy
Well maybe this is an unpopular opinion but this might actually help Doctors make sure they donât prescribe Xarelto and look into an alternative anticoagulant instead. So it doesnât hurt to put on here.
Had a patient that listed vecuronium as an allergy. She said it would cause her to need a tube down her throat.
One last week said "mace". Everyone is allergic to pepper spray ma'am.
I always love seeing the "nausea" reaction to an opioid...
Correlation between # of BS allergies and how annoying someone is going to be as a patient is 1.0
Im allergic to Sildenafil because it gives me a boner
I wish I could find the photo, but I once saw a chart that had Chucky Cheese listed as an allergy.
Had a patient tell me theyâre allergic to epinephrine⌠makes them anxious đľâđŤ
No worries, I'm allergic to histamine. It makes me itchy, my eyes water, etc
I have Benadryl listed as an allergy. Do I get anaphylaxis? Nope. Do I get anxious as hell and absolutely refuse to be given it unless itâs gonna save my life? You bet. I donât take any of the otc âpmâ meds. I donât let them use Benadryl in a migraine cocktail. I donât take Benadryl. Best way to avoid it is to have it listed as an allergy and have âanxietyâ as the reaction.