allergy-adverse-reaction-summary

Allergy & Adverse Reaction Summary

Overview

Pull all AllergyIntolerance resources for a patient. Categorize by type (drug, food, environmental). Grade severity and criticality. Flag high-risk allergies that require special clinical attention (anaphylaxis history, contrast dye, latex, NSAID sensitivity). Cross-reference against current medications to detect active conflicts. Output a structured summary with actionable safety flags.

FHIR Resources Used

Resource	Purpose	Search Parameters
AllergyIntolerance	Allergy and intolerance records	patient, clinical-status
MedicationRequest	Current medications for conflict detection	patient, status=active
Observation	IgE levels if available	patient, code (LOINC)

Instructions

Step 1: Pull All AllergyIntolerance Resources

Tool: fhir_search
resourceType: "AllergyIntolerance"
queryParams: "patient=[patient-id]"

Retrieve all records regardless of clinical status to capture full history. For each entry extract:

• code.coding: Substance (RxNorm for drugs, SNOMED CT for non-drugs)
• clinicalStatus: active, inactive, resolved
• verificationStatus: confirmed, unconfirmed, refuted, entered-in-error
• type: allergy vs intolerance
• category: food, medication, environment, biologic
• criticality: low, high, unable-to-assess
• reaction[]: Each reaction event
  • manifestation[].coding[].display: What happened (hives, anaphylaxis, rash, etc.)
  • severity: mild, moderate, severe
  • onset: When the reaction occurred
  • substance: Specific substance if different from the top-level code
• onsetDateTime: When allergy was first identified
• recorder: Who documented it
• note: Free-text notes

Step 2: Categorize Allergies

Group into four categories:

Drug Allergies (category = "medication"):

• Identify drug class from the substance code or name
• Check for class-level allergies vs specific drug allergies
• Note if the allergy is to a drug class (e.g., "penicillins") vs specific drug (e.g., "amoxicillin")