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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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The side effects of penicillin are bodily responses to penicillin and closely related antibiotics that do not relate directly to its effect on bacteria. A side effect is an effect that is not intended with normal dosaging. Some of these reactions are visible and some occur in the body's organs or blood. Penicillins are a widely-used group of medications that are effective for the treatment of a wide variety of bacterial infections in human adults and children as well as other species. Some side effects are predictable, of which some are common but not serious, some are uncommon and serious and others are rare. The route of administration of penicillin can have an effect on the development of side effects. An example of this is irritation and inflammation that develops at a peripheral infusion site when penicillin is administered intravenously. In addition, penicillin is available in different forms. There are different penicillin medications (penicillin G benzathine, penicillin G potassium, penicillin G procaine, and penicillin V) as well as a number of β-lactam antibiotics derived from penicillin (e.g. amoxicillin) generally also referred to as "penicillin".
Side effects may only last for a short time and then go away. Side effects can be relieved in some cases with non pharmacological treatment. Some side effects require treatment to correct potentially serious and sometimes fatal reactions to penicillin. Penicillin has not been found to cause birth defects.
Common adverse drug reactions (≥ 1% of people) associated with use of the penicillins include diarrhoea, hypersensitivity, nausea, rash, neurotoxicity, urticaria, and superinfection (including candidiasis). Infrequent adverse effects (0.1–1% of people) include fever, vomiting, erythema, dermatitis, angioedema, seizures (especially in people with epilepsy), and pseudomembranous colitis.
Penicillin (PCN or pen) is a group of antibiotics which include penicillin G (intravenous use), penicillin V (use by mouth), procaine penicillin, and benzathine penicillin (intramuscular use). Penicillin antibiotics were among the first medications to be effective against many bacterial infections caused by staphylococci and streptococci. Penicillins are still widely used today, though many types of bacteria have developed resistance following extensive use.
About 10% of people report that they are allergic to penicillin; however, up to 90% of this group may not actually be allergic. Serious allergies only occur in about 0.03%. All penicillins are β-lactam antibiotics.
Penicillin was discovered in 1928 by Scottish scientist Alexander Fleming. People began using it to treat infections in 1942. There are several enhanced penicillin families which are effective against additional bacteria; these include the antistaphylococcal penicillins, aminopenicillins and the antipseudomonal penicillins. They are derived from "Penicillium" fungi.
The term "penicillin" is often used generically to refer to benzylpenicillin (penicillin G, the original penicillin found in 1928), procaine benzylpenicillin (procaine penicillin), benzathine benzylpenicillin (benzathine penicillin), and phenoxymethylpenicillin (penicillin V). Procaine penicillin and benzathine penicillin have the same antibacterial activity as benzylpenicillin but act for a longer period of time. Phenoxymethylpenicillin is less active against gram-negative bacteria than benzylpenicillin. Benzylpenicillin, procaine penicillin and benzathine penicillin can be given by intravenous or intramuscular injections, but phenoxymethylpenicillin can be given by mouth because of its acidic stability.
Allergic rhinitis may be seasonal or perennial. Seasonal allergic rhinitis occurs in particular during pollen seasons. It does not usually develop until after 6 years of age. Perennial allergic rhinitis occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.
Allergic rhinitis may also be classified as Mild-Intermittent, Moderate-Severe intermittent, Mild-Persistent, and Moderate-Severe Persistent. Intermittent is when the symptoms occur 4 days/week and >4 consecutive weeks. The symptoms are considered mild with normal sleep, no impairment of daily activities, no impairment of work or school, and if symptoms are not troublesome. Severe symptoms result in sleep disturbance, impairment of daily activities, and impairment of school or work.
Allergic rhinitis, also known as hay fever, is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air. Signs and symptoms include a runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes. The fluid from the nose is usually clear. Symptom onset is often within minutes following exposure and they can affect sleep, the ability to work, and the ability to concentrate at school. Those whose symptoms are due to pollen typically develop symptoms during specific times of the year. Many people with allergic rhinitis also have asthma, allergic conjunctivitis, or atopic dermatitis.
Allergic rhinitis is typically triggered by environmental allergens such as pollen, pet hair, dust, or mold. Inherited genetics and environmental exposures contribute to the development of allergies. Growing up on a farm and having multiple siblings decreases the risk. The underlying mechanism involves IgE antibodies attaching to the allergen and causing the release of inflammatory chemicals such as histamine from mast cells. Diagnosis is usually based on a medical history in combination with a skin prick test or blood tests for allergen-specific IgE antibodies. These tests, however, are sometimes falsely positive. The symptoms of allergies resemble those of the common cold; however, they often last for more than two weeks and typically do not include a fever.
Exposure to animals in early life might reduce the risk of developing allergies to them later. A number of medications may improve symptoms including nasal steroids, antihistamines such as diphenhydramine, cromolyn sodium, and leukotriene receptor antagonists such as montelukast. Medications are, however, not sufficient or are associated with side effects in many people. Exposing people to larger and larger amounts of allergen, known as allergen immunotherapy, is often effective. The allergen may be given as injections just under the skin or as a tablet under the tongue. Treatment typically lasts three to five years after which benefits may be prolonged.
Allergic rhinitis is the type of allergy that affects the greatest number of people. In Western countries, between 10–30% of people are affected in a given year. It is most common between the ages of twenty and forty. The first accurate description is from the 10th century physician Rhazes. Pollen was identified as the cause in 1859 by Charles Blackley. In 1906, the mechanism was determined by Clemens von Pirquet. The link with hay came about due to an early (and incorrect) theory that the symptoms were brought about by the smell of new hay.
Identifying a drug allergy can sometimes be the hardest part. Sometimes drug allergies are confused with nonallergic drug reactions because they both cause somewhat similar reactions. Symptoms of a drug allergy can include, but are not limited to, the following list.
- Hives
- Itching
- Rash
- Fever
- Facial swelling
- Shortness of breath due to the short-term constriction of lung airways or longer-term damage to lung tissue
- Anaphylaxis, a life-threatening drug reaction (produces most of these symptoms as well as low blood pressure)
- Cardiac symptoms such as chest pain, shortness of breath, fatigue, chest palpitations, light headedness, and syncope due to a rare drug-induced reaction, eosinophilic myocarditis
When a medication causes an allergic reaction, it is called an allergen. The following is a short list of the most common drug allergens:
- Antibiotics
- Penicillin
- Sulfa drugs
- Tetracycline
- Analgesics
- Codeine
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Antiseizure
- Phenytoin
- Carbamazepine
A subset of children with acute, rapid-onset of tic disorders and obsessive compulsive disorder (OCD) are hypothesized to be due to an autoimmune response to group A beta-hemolytic streptococcal infection (PANDAS).
A typical allergic reaction to alpha-gal has a delayed onset, occurring 3–8 hours after the consumption of mammalian meat products, instead of the typical rapid onset with most food allergies. After the delayed onset, the allergic response is typical of most food allergies, and especially an IgE mediated allergy, including severe whole-body itching, hives, angioedema, gastrointestinal upset, and possible anaphylaxis. In 70% of cases the reaction is accompanied by respiratory distress and as such is particularly harmful to those with asthma.
Alpha-gal allergies are the first food allergies to come with the possibility of delayed anaphylaxis. It is also the first food-related allergy to be associated with a carbohydrate, rather than a protein.
Post-streptococcal glomerulonephritis (PSGN) is an uncommon complication of either a strep throat or a streptococcal skin infection. It is classified as a type III hypersensitivity reaction. Symptoms of PSGN develop within 10 days following a strep throat or 3 weeks following a GAS skin infection. PSGN involves inflammation of the kidney. Symptoms include pale skin, lethargy, loss of appetite, headache, and dull back pain. Clinical findings may include dark-colored urine, swelling of different parts of the body (edema), and high blood pressure. Treatment of PSGN consists of supportive care.
The conjunctiva is a thin membrane that covers the eye. When an allergen irritates the conjunctiva, common symptoms that occur in the eye include: ocular itching, eyelid swelling, tearing, photophobia, watery discharge, and foreign body sensation (with pain).
Itching is the most typical symptom of ocular allergy, and more than 75% of patients report this symptom when seeking treatment. Symptoms are usually worse for patients when the weather is warm and dry, whereas cooler weather with lower temperatures and rain tend to assuage symptoms. Signs in phlyctenular keratoconjunctivitis include small yellow nodules that develop over the cornea, which ulcerate after a few days.
A study by Klein et al. showed that in addition to the physical discomfort allergic conjunctivitis causes, it also alters patients' routines, with patients limiting certain activities such as going outdoors, reading, sleeping, and driving. Therefore, treating patients with allergic conjunctivitis may improve their everyday "quality of life."
Pneumonia occurs when the lungs become infected, causing inflammation (swelling). Symptoms of pneumonia usually include:
- Fever (but older people may have lower than normal body temperature)
- Cough
- Shortness of breath
- Chills
- Sweating
- Chest pain that comes and goes with breathing
- Headache
- Muscle pain
- Excessive tiredness
- Nails may turn blue from lack of oxygen
Treatment usually involves adrenaline (epinephrine), antihistamines, and corticosteroids.
If the entire body is involved, then anaphylaxis can take place, which is an acute, systemic reaction that can prove fatal.
Some examples:
- Allergic asthma
- Allergic conjunctivitis
- Allergic rhinitis ("hay fever")
- Anaphylaxis
- Angioedema
- Urticaria (hives)
- Eosinophilia
- Penicillin allergy
- Cephalosporin allergy
- Food allergy
- Sweet itch
Alpha-gal allergy, also known as meat allergy or Mammalian Meat Allergy (MMA), is a reaction to galactose-alpha-1,3-galactose (alpha-gal), whereby the body is overloaded with immunoglobulin E (IgE) antibodies on contact with the carbohydrate. The alpha-gal molecule is found in all mammals apart from Old World monkeys and the apes, which include humans. Anti-Gal is a human natural antibody which interacts specifically with the mammalian carbohydrate structure Gal alpha 1-3Gal beta 1-4GlcNAc-R, termed, the alpha-galactosyl epitope. Whereas anti-Gal is abundant in humans, apes and Old World monkeys, it is absent from New World monkeys, prosimians and nonprimate mammals.
Bites from certain ticks, such as the lone star tick in the US, which can transfer this carbohydrate to the victim have been implicated in the development of this delayed allergic response which is triggered by the consumption of mammalian meat products. Despite myths to the contrary, an alpha-gal allergy does not require the afflicted to become a vegetarian, as poultry and fish do not trigger a reaction.
The allergy most often occurs in the central and southern United States, which corresponds to the distribution of the lone star tick. In the Southern United States, where the tick is most prevalent, allergy rates are 32% higher than elsewhere. However, as doctors are not required to report the number of patients suffering the alpha-gal allergies, the true number of affected individuals is unknown. While there is no known cure, symptoms of the allergy may recede over time. Some patients report observing symptoms for over 20 years.
The signs and symptoms of allergies in a child are:
- Chronic symptoms resembling the cold that last more than a week or two.
- Cold-like symptoms that appear during the same time each year
- Repeated difficulty breathing, wheezing and breathing
- Cold-like symptoms that happen at night
- Cold-like symptoms that happen during exercise
- Chronic rashes or patches of skin that are dry, itchy, look like scales
- Cold-like symptoms that appear after eating a certain food
- Hives
- Swelling of face, arms or legs
- Gagging, coughing or wheezing, vomiting or significant abdominal pain
- Itching or tingling sensations in the mouth, throat or ears
Many allergens such as dust or pollen are airborne particles. In these cases, symptoms arise in areas in contact with air, such as eyes, nose, and lungs. For instance, allergic rhinitis, also known as hay fever, causes irritation of the nose, sneezing, itching, and redness of the eyes. Inhaled allergens can also lead to increased production of mucus in the lungs, shortness of breath, coughing, and wheezing.
Aside from these ambient allergens, allergic reactions can result from foods, insect stings, and reactions to medications like aspirin and antibiotics such as penicillin. Symptoms of food allergy include abdominal pain, bloating, vomiting, diarrhea, itchy skin, and swelling of the skin during hives. Food allergies rarely cause respiratory (asthmatic) reactions, or rhinitis. Insect stings, food, antibiotics, and certain medicines may produce a systemic allergic response that is also called anaphylaxis; multiple organ systems can be affected, including the digestive system, the respiratory system, and the circulatory system. Depending on the rate of severity, it can cause a skin reactions, bronchoconstriction, swelling, low blood pressure, coma, and death. This type of reaction can be triggered suddenly, or the onset can be delayed. The nature of anaphylaxis is such that the reaction can seem to be subsiding, but may recur throughout a period of time.
Allergic conjunctivitis is inflammation of the conjunctiva (the membrane covering the white part of the eye) due to allergy. Although allergens differ among patients, the most common cause is hay fever. Symptoms consist of redness (mainly due to vasodilation of the peripheral small blood vessels), edema (swelling) of the conjunctiva, itching, and increased lacrimation (production of tears). If this is combined with rhinitis, the condition is termed allergic rhinoconjunctivitis.
The symptoms are due to release of histamine and other active substances by mast cells, which stimulate dilation of blood vessels, irritate nerve endings, and increase secretion of tears.
Treatment of allergic conjunctivitis is by avoiding the allergen ("e.g.", avoiding grass in bloom during "hay fever season") and treatment with antihistamines, either topical (in the form of eye drops), or systemic (in the form of tablets). Antihistamines, medications that stabilize mast cells, and nonsteroidal anti-inflammatory drugs (NSAIDs) are generally safe and usually effective.
Among the signs of subacute bacterial endocarditis are:
- Malaise
- Weakness
- Excessive sweat
- Fever
Type IV allergy, also known as allergic contact dermatitis, involves a delayed skin rash that is similar to poison ivy with blistering and oozing of the skin ("see urushiol-induced contact dermatitis"). It can be diagnosed through a positive skin patch test, although a negative test does not rule out a latex allergy.
Severe irritation takes place if a latex catheter is inserted in the urinary tract of a person allergic to latex. That is especially severe in case of a radical prostatectomy due to the open wound there and the exposure lasting e.g. two weeks. Intense pain may indicate such situation.
NSAID or nonsteroidal anti-inflammatory drug hypersensitivity reactions encompasses a broad range of allergic or allergic-like symptoms that occur within minutes to hours after ingesting aspirin or other NSAID nonsteroidal anti-inflammatory drugs. Hypersensitivity drug reactions differ from drug toxicity reactions in that drug toxicity reactions result from the pharmacological action of a drug, are dose-related, and can occur in any treated individual (see nonsteroidal anti-inflammatory drugs section on adverse reactions for NSAID-induced toxic reactions); hypersensitivity reactions are idiosyncratic reactions to a drug. Although the term NSAID was introduced to signal a comparatively low risk of adverse effects, NSAIDs do evoke a broad range of hypersensitivity syndromes. These syndromes have recently been classified by the European Academy of Allergy and Clinical Immunology Task Force on NSAIDs Hypersensitivity. The classification organizes the hypersensitivity reactions to NSAIDs into the following five categories:
- 1) NSAIDs-exacerbated respiratory disease (NERD) is an acute (immediate to several hours) exacerbation of bronchoconstriction and other symptoms of asthma (see aspirin-induced asthma) in individuals with a history of asthma and/or nasal congestion, rhinorrhea or other symptoms of rhinitis and sinusitis in individuals with a history of rhinosinusitis after ingestion of various NSAIDs, particularly those that act by inhibiting the COX-1 enzyme. NERD does not appear to be due to a true allergic reaction to NSAIDs but rather at least in part to the more direct effects of these drugs to promote the production and/or release of certain mediators of allergy. That is, inhibition of cellular COX activity deprives tissues of its anti-inflammatory product(s), particularly prostaglandin E2 while concurrently shuttling its substrate, arachidonic acid, into other metabolizing enzymes, particularly 5-lipoxygenase (ALOX5) to overproduce pro-inflammatory leukotriene and 5-Hydroxyicosatetraenoic acid metabolites and 15-lipoxygenase (ALOX15) to overproduce pro-inflammatory 15-Hydroxyicosatetraenoic acid metabolites, including eoxins; the condition is also associated with a reduction in the anti-inflammatory metabolite, lipoxin A4, and increases in certain pro-allergic chemokines such as eotaxin-2 and CCL7.
- 2) NSAIDs-exacerbated cutaneous disease (NECD) is an acute exacerbation of wheals and/or angioedema in individuals with a history of chronic urticaria. NECD also appears due to the non-allergic action of NSAIDs in inhibiting the production of COX anti-inflammatory metabolites while promoting the production 5-lipoxygenase and 15-lipoxygenase pro-inflammatory metabolites and the overproduction of certain pro-allergic chemokines, e.g. eotaxin-1, eotaxin-2, RANTES, and interleukin-5.
- 3) NSAIDs-induced urticarial disease (NEUD) is the acute development of wheals and/or angioedema in individuals with no history of chronic NSAIDs-induced urticaria or related diseases. The mechanism behind NEUD is unknown but may be due to the non-allergic action of NSAIDs in promoting the production and/or release of allergy mediators.
- 4) Single NSAID-induced urticarial/angioedema or anaphylaxis (SNIUAA) is the acute development of urticarial, angioedema, or anaphylaxis in response to a single type of NSAID and/or a single group of NSAIDs with a similar structure but not to other structurally unrelated NSAIDs in individuals with no history of underlying relevant chronic diseases. SNIUAA is due to a true IgE-mediated allergy reaction.
- 5 Single NSAID-induced delayed reactions (SNIDR) are a set of delayed onset (usually more than 24 hour) reactions to NSAIDs. SNIDR are most commonly skin reactions that may be relatively mild moderately severe such as maculopapular rash, fixed drug eruptions, photosensitivity reactions, delayed urticaria, and contact dermatitis or extremely severe such as the DRESS syndrome, acute generalized exanthematous pustulosis, the Stevens–Johnson syndrome, and toxic epidermal necrolysis (also termed Lyell's syndrome). SNIDR result from the drug-specific stimulation of CD4+ T lymphocytes and CD8+ cytotoxic T cells to elicit a delayed type hypersensitivity reaction.
Cat allergy in humans is an allergic reaction to one or more allergens produced by cats. The most common of these allergens are the glycoprotein Fel d 1, secreted by the cat's sebaceous glands and Fel d 4, which is expressed in saliva. An allergic reaction is a histamine reaction that is usually characterized by coughing, wheezing, chest tightening, itching, nasal congestion, rash, watering eyes, sneezing, chapped lips, and similar symptoms. In some severe cases, reactions may progress rapidly to cause the victim's airway to become inflamed and close up, requiring emergency medical attention. Those with severe, life-threatening cat allergies face tremendous challenges due to lack of public awareness about anaphylactic cat allergies, and do not enjoy the same conscientiousness from the public as those with a food allergy might, due to widespread knowledge of allergies to allergens such as nuts or dairy.
OAS sufferers may have any of a number of allergic reactions that usually occur very rapidly, within minutes of eating a trigger food. The most common reaction is an itching or burning sensation in the lips, mouth, ear canal, or pharynx. Sometimes other reactions can be triggered in the eyes, nose, and skin. Swelling of the lips, tongue, and uvula and a sensation of tightness in the throat may be observed. It can seldom result in anaphylaxis. If a sufferer swallows the food, and the allergen is not destroyed by the stomach acids, there is a good chance that there will be a reaction from histamine release later in the gastrointestinal tract. Vomiting, diarrhea, severe indigestion, or cramps may occur. Rarely, OAS may be severe and present as wheezing, vomiting, hives and low blood pressure.
Allergies are caused by an oversensitive immune system, leading to a misdirected immune response. The immune system normally protects the body against harmful substances such as bacteria and viruses. Allergy occurs when the immune system reacts to substances (allergens) that are generally harmless and in most people do not cause an immune response.
- Animal hair and dander
- cockroach calyx
- dust mite excretion