- - IgE (side chain) penicillin - T cell () sulfamethoxazole - NSAIDs

- Beta-lactam - side chain -

< 10 anaphylaxis 0.015 0.004 . penicillins 10-20 skin test Skin test : - 60

18.7 penicillin ampicillin / amoxicillin - diamino acyl side chain - Epstein-Barr virus, leukemia allopurinol ( 69-100)

0.9 - 2.8 * anaphylaxis 0.1 0.0001 * Penicillin ( 10.9-13.3) 1 cep. = 7.2 10.9% 2 cep = 1.9% 3 cep = 0.8 %7 cephalosporin 86.7

.. generation

* Cephalosporin ( 1 , 2 , 3 )* Cephalosporin side chain (R1)

* .. 1987 - 50 penicillin skin test penicillin skin test imipenem* .. 2000 - imipenem penicillin 9.5

* Sulfonamide IgE metabolism

IgE () - Anaphylaxis , urticaria,angioedema Non-IgE - Hemolytic anamia, Interstitial nephritis, maculopapular exanthem, SJS

* Skin test: ( quinolone histamine)* Desensitization : * IgE

* 1:1,000- 1:10,000 * 3 -13 * 60 - phenytoin : 2.3 4.5 :10,000 - Carbamazepine : 1-4.1 : 10,000 * aromatic anticonvulsants 70 - 80

* phenytoin , phenobarbital, carbamazepine * BZD, valproic acid, gabapentin , topiramate, vigabatrin

. 30 40 / ASA NSAIDs 15 60 - nasal congestion, severe asthma, anaphylaxis (dose dependent)

ASA & NSAIDs : urticaria, angioedema,pruritus, dyspnea, rhinitis :Celecoxib = 1.3 6.6% :Paracet = 15.6% :nimesulide = 2.8-17.6% :meloxicam = 4.1%

- paracetamol salsalate COX2 - Graded challenge ASA 150 325 650 mg NSAIDs - Desensitization () ASA 3-10 mg