(Allergy Skin test)

( )
(Allergy Skin Test)






skin test
skin test
(Allergy Skin test)

skin test

(Allergy Skin test)

1.
2. -
3.
4.

1. 7
2.
7
3.

4.
5.

(Allergy Skin test) .. 51

skin test
skin test local anasthetics , penicillin , B- lactam
sulfa-methoxazole skin test
intradermal test skin test penicillin -foreign anti
toxins , cephalosporin - anti tuberculosis drugs , insulin - anti convulsants , chymopapain quinidine , local anasthetics - cis- platinum , muscle relaxants - penicillamine , thiopental
skin test
skin test 3
1. (Scratch test )
extract
dermis nonspecific reaction trauma
false positive extract

2. (prick- puncture test )

70%

6 4

( prick test )
epidermis
puncture test
epidermis 1
immediate hypersensitivity reaction 8-10 histamine
15-20 wheal flare

(Allergy Skin test) .. 51

1 (Skin prick test . SPT)

3. (Intradermal skin test )

10



1: 500 (
1: 5000 )
buffer saline tuberculin (1 .) 26 27
0.05 . 0.02 .
deltoid
4
buffer saline (negative control)
histamine 1: 10000
positive control 20

placebo placebo negative control 0.9% NSS

skin test placebo
placebo skin test placebo
placebo negative control
(Allergy Skin test) .. 51

(Intradermal skin test )

4

urticaria

(Allergy Skin test) .. 51

skin test penicillin

1. skin test
skin test

2. 2
2.1 Ig E
, angioedema ,bronchospasm anaphylaxis
2.2 Ig E
nephritis , exfoliative dermatitis, Steven-Johnson Syndrome, Toxic Epidermal Necrolysis(TEN),
hemolytic anemia, erythrema multiforme
penicillin skin prick test intradermal test

100%
Ig E antibody
skin test
3. skin test
skin test antihistamines tricyclic antidepressant 48
skin test sympathomimetic agents 4
skin test
4. control
positive control histamine morphine
negative control
1 cephalosporin

cefotaxime
Cefuroxime
Cefazolin
Ceftazidime
ceftriaxone

(mg/ml)
95
90
330
250
250

(Allergy Skin test) .. 51

10
10
10
10
10

1 () cephalosporin

gentamicin
Clindamycin
co-trimoxazole
Erythromycin
Vancomycin
Azithromycin
Nafcillin

(mg/ml)
40
150
80(sulfa component)
50
50
100
250

10
10
100
1,000
10,000
10,000
10,000

1. Cefotaxime 1 g/ml
Cefotaxime 1000m g/ 10 ml(100 mg/ml)
95 mg/ml 10 skin test
9.5 mg/ml
( cefotaxime 1000 mg/10 ml (100 mg/ml) --> 9.5 mg/ml)
C1V1
=
C2V2
(100 mg/ml) x 0.1 ml
=
(9.5 mg/ml ) x V2
V2
=
(100 mg/ml )x 0.1 ml = 1.05 ml (9.5 mg/ml)
Cefotaxime 1 g/10 ml 0.1 ml 0.9% NaCl 1.05 mL
2. Ceftriaxone 1 g/ml
Ceftriaxone 1 g/10ml 250 mg/ml
10 skin test 25 mg/ml
( Ceftriaxone 1 g/10ml (100 mg/ml) --> 25 mg/ml)
C1V1
=
C2V2
(100 mg/ml) x 0.1 ml
=
( 25 mg/ml) x V2
V2
=
(100 mg /ml)x 0.1 ml = 0.4 ml (25 mg/ml)
Ceftriaxone 1 g/10 ml 0.1 ml 0.9% NaCl 0.4 mL

(Allergy Skin test) .. 51

3. Gentamicin 80 mg/2ml
Gentamicin 80 mg/2ml 40
mg/ml 10 skin test 4 mg/ml
( Gentamicin 80 mg/2ml --> 4 mg/ml)
C1V1
=
C2V2
(40 mg /ml)x 0.1 ml
=
(4 mg/ml )x V2
V2
=
(40 mg /ml) x 0.1 ml = 1 ml (4 mg/ml)
Gentamicin 80 mg/2ml 0.1 ml 0.9% NaCl 1 mL
4. Co-trimoxazole Injection (sulfamethoxazole 80mg/ml , trimethoprim 16mg/ mL)
Co-trimoxazole ( sulfa component sulfamethoxazole
80 mg/ml) 80 mg/ml 100
skin test 0.8 mg/ml
( Co-trimoxazole ( sulfa component sulfamethoxazole 80 mg/ml) --> 0.08 mg/ml)
C1V1
=
C2V2
(80 mg /ml)x 0.01 ml
=
(0.8 mg/ml) x V2
V2
=
(80 mg/ml)x 0.01 ml = 1 ml (0.8 mg/ml)
Co-trimoxazole ( sulfa component sulfamethoxazole 80 mg/ml)
0.01ml(~0.1) 0.9% NaCl 1 mL
5. Penicillin G sodium/(500,000 units/ml)
Penicillin G sodium/potassium 500,000 units/ml
(5,000 units/ml)*(5 units/ml) skin test
( Penicillin G sodium/potassium 500,000 units/ml --> 5,000 units/ml -->5 units/ml)
C1V1
=
C2V2
(500,000 units/ml) x 0.1 ml =
(5,000 unit/ml )x V2
V2
=
500,000 units x 0.1 ml = 100 ml (5,000 unit/ml)
Penicillin G sodium/potassium 500,000 units/ml 0.1 ml
0.9% NaCl 100 mL 5,000 unit/ml ( anaphylaxis)
5 units/mL anaphylaxis (dilute 0.1 mL 5,000
units/mL 0.9% NaCl 100 mL)

(Allergy Skin test) .. 51

6. Ampicillin 1000 mg/ 10 ml (dilute solvent 7.4 mlOnly/250 mg dilute solvent

5 ml Only) ampicillin 1,000 mg/7.4 ml (100 mg/ml)
2.5 mg/ml skin test ( ampicillin 7.4 ml
1,000 mg/10 ml --> 2.5 mg/ml)
C1V1
=
C2V2
100 mg/ml x 0.025 ml(~0.1) =
2.5mg x V2
V2
=
100 mg/ml x 0.025 ml = 1 ml (2.5 mg)
ampicillin 1,000 mg/ 10 ml 0.025(~0.1) ml 0.9% NaCl
1 mL

1.
2.
3.

test solutions
positive control reactive
skin tests
3.1 hydrocortisone 100 mg IV
3.2 diphenhydramine 50 mg IV
3.3 epinephrine 1:1000 S.C.

skin test
1. histamine
allergen reactivity (forearm)
reactivity
2. histamine allergen
6
50 reactive total specific
IgE reactivity
3.
reactivity (menstrual cycle)
reactivity 12-16 ovulation
estrogen
4. Circadian variation reactivity

(Allergy Skin test) .. 51

10

5.
6.
1
skin test astemizole
30-60 ketotifen 5 imipramine 10
antihistamine 3-10 oral corticosteroid
( 1 skin reactivity
topical steroid reactivity
test 2-3
7. skin test eczema
chronic hemodialysis
diabetic neuropathy eczema
systemic anaphylaxis
1 mast cell degranulation
false nagative
8. allergen reactivity histamine

1.

30

2. IgE
IgE

penicillin 10 20
penicillin skin test

(Allergy Skin test) .. 51

11

Skin Prick Test

1.
2 6
2.

3.

15
Blood test
Patch test
contact dermatitis
48 nickle

(Allergy Skin test) .. 51

12

, , . (2541) . . :
.
Charles F. Lacy , Lora L. Armstrong , Morton P. Goldman , Leonard L. Lance. (2000).
Drug Information Handbook. 8th Edition. : Lexi - comp Inc., USA.
Gerald K. McEvoy. Editor. AHFS Drug Informatio. (1998). American Society of Health
System Pharmacists.USA.
Joseph T. DiPiro , Robert L. Talbert , Gary C. Yee , Gary R. Matzke , Barbara G. Wells ,
L. Michael Posey. Editors.(1999). Pharmacotherapy A Pathophysiologic Approach.
4th Edition. : Appleton & Lange. USA.
http://www.ramaclinic.com/board/viewtopic.php 10 . 51
http://www.pharmacy.ac.th 10 . 51
http://www.dermnetnz.org/procedure/patch-test. 10 . 51
http://drug.pharmacy.psu.ac.th/Question.asp. 10 . 51
http://drug.pharmacy.psu.ac.th/Question.asp. 10 . 51
http://www.vibhavadi.com/web/health_detail.php. 10 . 51
http://gotoknow.org/blog/skin/125716. 10 . 51
http://www.healthinessplus.com/board/index.php. 10 . 51
http://www.idthai.org/Main/QA-2003.htm 10 . 51
http://www.pharm.su.ac.th/thai/Organizations/DIS/Webboards/showQAnswer.asp.
10 . 51
http://www.si.mahidol.ac.th/th/department/oto_rhino_laryngology/Articles/nose/doc007.html
10 . 51

(Allergy Skin test) .. 51