Table 3.

Circumstances in which DPTs are contraindicated or not preferred.

Patient related factors •  Uncontrolled asthma •  Uncontrolled underlying chronic disease •  Pregnancy •  Use of β-blockers •  If underlying heart disease is a contraindication for the use of adrenaline

Index drug hypersensitivity reaction •  Vasculitis syndromes •  Bullous exanthemas (Steven Johnson syndrome, toxic epidermal necrolysis, bullous fixed drug eruptions, etc.) •  Acute generalized exanthematous pustulosis •  Drug-induced autoimmune disease (systemic lupus erythematosus, pemphigus vulgaris, etc.) •  Drug induced hypersensitivity syndromes (DRESS) •  Involvement of specific organ systems (hepatitis, nephritis, blood dyscrasias, etc.) •  Severe anaphylaxis

Culprit drug •  Unlikely to be needed and several structurally unrelated alternatives exist