Based on the information provided in the case overview, it appears that the plaintiff suffered from multiple adverse drug reactions involving several prescription medications. Of particular note, the plaintiff notes a past medical history of allergy to sulfa drugs, which is well established to be associated with Stevens-Johnson syndrome. Sulfa drugs refer to a class of medications that contain a sulfonamide group in their chemical structure. In susceptible individuals, the sulfonamide structure can be activated metabolically and trigger an allergic reaction. Ciprofloxacin (an antibiotic prescribed to the plaintiff) does not contain this chemical group and is, therefore, not a sulfa drug. However, it is unclear as to whether any sulfa-containing drugs such as sulfamethoxazole-trimethoprim or erythromycin-sulfisoxazole were prescribed. The patient also notes an allergy to sulfate-containing drugs. Many medications contain sulfate components and these are not allergenic. In fact, sulfates are a normal component of the human body and there is no allergic cross-reactivity between drugs that are sulfate salts and drugs that are sulfonamides. Stevens-Johnson syndrome is a serious side effect of several medications and includes symptoms such as sloughing of the skin, significant blistering, and associated fever. Additionally, symptoms such as dehydration, dementia, and cardiac arrest are complications associated with many prescription medications including Ciprofloxacin and/or Prednisone.
I have a PhD in Pharmacology and operate a federally funded research laboratory that is focused, in part, on understanding mechanisms associated with drug-drug interactions and drug toxicity. I also teach pharmacokinetics and molecular pharmacology to medical students and graduate students. It is the responsibility of a physician to obtain detailed medical information from a patient prior to prescribing a medication. This includes acquiring information regarding drug allergy and all current and previous medications. Additionally, a physician must know the potential for drug-drug interactions in a patient prescribed multiple drugs and make accommodations for this. At the level of the pharmacy, consultation between the patient and pharmacist provides a secondary level of safeguard that can ensure that medications are administered safely.