Past medical and drug history

The patient's full past medical history, including drug history, should be documented, including other allergic and all non-allergic illnesses.

The possibility of a psychiatric history should be considered. Some clusters of symptoms at presentation are more likely to be linked with psychiatric diagnoses. People presenting with multiple symptoms, and concerns over many foods and other environmental problems, have been shown to be more at risk of symptoms of depression or anxiety.10 Parents may make claims of multiple food allergies in their children. Such claims have been known to be sufficiently extreme to be diagnosed as Munchausen's by Proxy.11

The assessment of the patient should include a drug history. This will aid the identification of drugs that may be the cause of the patient's symptoms, as in the association between urticaria and aspirin or between asthma and other non-steroidal anti-inflammatory drugs.

Beta blockers are said to make the possibility of a severe anaphylactic reaction more likely, and may modify the advice and emergency treatment the clinician gives to the patient.

A drug history will also enable the clinician to optimise the patient's therapy, and ensure they have the necessary emergency drugs in their possession and are confident in the timing and method of their use.

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