nach oben

Drug Safety

Erschienen in:

01.09.2001 | Practical Drug Safety

Preventing and Managing Drug-Induced Anaphylaxis

verfasst von: Kerry L. Drain, Dr Gerald W. Volcheck

Erschienen in: Drug Safety | Ausgabe 11/2001

Einloggen, um Zugang zu erhalten

Abstract

Drug-induced anaphylaxis and anaphylactoid reactions have increased in frequency with more widespread use of pharmaceutical agents. Anaphylaxis is a systemic, severe immediate hypersensitivity reaction caused by immunoglobulin (Ig) E-mediated immunological release of mediators of mast cells and basophils. An anaphylactoid reaction is an event similar to anaphylaxis but is not mediated by IgE.

The incidence of anaphylactic or anaphylactoid reactions differs amongst classes of medications. Antibacterials are the most usual offenders, and penicillins are the most studied. Other compounds commonly causing reactions include nonsteroidal anti-inflammatory drugs, anaesthetics, muscle relaxants, latex and radiocontrast media.

Prevention, if possible, is the purpose of detailed patient history taking and physical examination. Simple strategies can be employed to decrease the risk of anaphylaxis. These include consideration of the route of drug administration, identification of patients with known causes of anaphylaxis, and the knowledge that certain medications cross react and are contraindicated in those with known history of anaphylaxis. Tests are available, and include IgE-specific skin tests and radioallergosorbent tests. Penicillins are the only compounds whose antigenic determinants are well documented, it is therefore difficult to determine the negative predictive value of other compounds tested. Oral challenge remains an alternative, though entails risk. Desensitisation procedures, as well as gradual dose escalation protocols, are available and can be implemented based on patient history and diagnostic testing.

The management of anaphylaxis is based on control of the airway, breathing and circulation. Treatment consists of epinephrine (adrenaline) and supportive measures. Rapid diagnosis and intervention are important in these life-threatening reactions. After stabilisation, all individuals with a documented history of anaphylaxis require a Medic-Alert bracelet or necklace, and an identification card for their wallet or purse.

Kagy L, Blaiss MS. Anaphylaxis in children. Pediatr Ann 1998 Nov; 27(11): 727–34PubMed

Freeman TM. Anaphylaxis: Diagnosis and Treatment. Primary Care; Clinics in Office Practice 1998 Dec; 25(4): 809–17PubMedCrossRef

Hess DA, Rieder MJ. The Role of Reactive Drug Metabolites in Immune-Mediated Adverse Drug Reactions. Ann Pharmacother 1997 Nov; 31(11): 1378–87PubMed

Macy E. Elective penicillin skin testing and amoxicillin challenge: Effect on outpatient antibiotic use, cost and clinical outcomes. J Allergy Clin Immunol 1998 Aug; 102(8): 281–5PubMedCrossRef

Lieberman P. Anaphylaxis and Anaphylactiod Reactions. In: Middleton E, Reed CE, Ellis EF, et al., editors. Allergy principles and practice. St. Louis: Mosby, 1998: 1079–91

Douglas DM, Sukenick E, Andrade WP et al. Biphasic systemic anaphylaxis: An inpatient and outpatient study. J Allergy Clin Immunol 1994 Jun 93(6): 977–85PubMedCrossRef

Atkinson TP, Kaliner MA. Anaphylaxis. Med Clin Nor Am 1992; 76: 841–55

Boston Collaborative Drug Surveillance Program: Brief reports: drug induced anaphylaxis, JAMA 1973; 224: 613

Porter J, Jick H. Boston Collaborative Drug Surveillance Programs: drug induced anaphylaxis, convulsions, deafness and extrapyramidal symptoms. Lancet 1977; I: 587CrossRef

10.

Amornmarn L, Bernard L, Kumar N, et al. Anaphylaxis admissions to a university hospital. J allergy Clin Immunol 1992; 89Suppl.: 349

11.

Bresser H, Sander C, Rakoski J. Anaphylactic emergencies in Munich. J Allergy Clin Immunol 1995; 95: 386

12.

Klein JS, Yocum MN. Underreporting of anaphylaxis in a community emergency room. J Allergy Clin Immunol 1995; 95: 637–8PubMedCrossRef

13.

Yocum MW, Butterfield JH, Klein JS, et al. Epidemiology of anaphylaxis in Olmstead County: a population-based study. J Allergy Clin Immunol 1999: 104: 452–6PubMedCrossRef

14.

Weiss ME, Atkinson NF. Immediate hypersensitivity reactions to penicillin and related antibiotics. Clin Allergy 1988: 18: 515–40PubMedCrossRef

15.

Neugut AI, Ghatak AT, Miller RL. Anaphylaxis in the United States. Arch Intern Med 2001; 161: 15–21PubMedCrossRef

16.

Falliers CJ. Aspirin and subtypes of asthma: risk factor analysis. J Allergy Clin Immunol 1973; 52: 141PubMedCrossRef

17.

Manning ME, Stevenson DD, Mathison DA. Reactions to aspirin and other nonsteroidal anti-inflammatory drugs. Immunol Allergy Clin North Am 1992 Mar; 12(3): 611–31

18.

Strom BL, Carson JUL, Morse ML, et al. The effect of indication on hypersensitivity reactions associated with zomepirac sodium and other non-steroidal anti-inflammaotry drugs. Arthritis Rheum 1987; 30: 1142PubMedCrossRef

19.

Settipane GA, Chafee FH, Klein DE. Aspirin intolerance: II. A prospective study in an atopic and normal population. J Allergy Clin Immunol 1974; 53: 200PubMedCrossRef

20.

Kemp SF, Lockey RF, Lieberman P, et al. Anaphylaxis, a review of 266 cases. Arch Intern Med 1995; 155: 1749–54PubMedCrossRef

21.

Laxenaire MC, Moneret-Vautrin DA, Widmer S, et al. Substances anesthesiques responsables de chocs anaphylactiques. Enquete multicentrique francaise. Ann Fr Anesth Reanim 1990; 9: 501–6PubMedCrossRef

22.

Laxenaire MC, Le Groupe d’etude des reactions anaphylactoides peranesthesiques. Substances responsables des chocs anaphylactiques peranesthesiques: troisieme enquete multicentrique francaise (dy1992-1994). Ann Fr Anesth Reanim 1996; 15: 1211–8PubMedCrossRef

23.

Gueant JL, Aimone-Gastin I, Namour F, et al. Diagnosis and pathogenesis of the anaphylactic and anaphylactoid reactions to anaesthetics. Clin Exp Allergy 1998; 28: 65–70PubMedCrossRef

24.

Eggleston ST, Lush LW. Understanding allergic reactions to local anesthetics. Ann Pharmacother 1996; 30: 851–7PubMed

25.

Giovannitti JA, Bennett CK. Assessment of allergy to local anesthesia. J Am Dent Assoc 1979; 98(5): 701–6PubMed

26.

Lagier F, Vervloet D, Lhermet I et al. Prevalance of latex allergy in operating room nurses. J Allergy Clin Immunol 1993; 90: 319–22CrossRef

27.

Kelly KJ, Walsh-Kelly CM. Latex allergy: A patient and health care system emergency. J Emerg Nurs 1998 Dec; 24(6): 539–45PubMedCrossRef

28.

Latex Hypersensitivity Committee of the American College of Allergy, Asthma, and Immunology: Latex allergy an emerging health care problem. Ann Allergy Asthma Immunol 1995; 75: 19–21

29.

Katayama H, Yamaguchi K, Kozuka T, et al. Adverse reactions to ionic and nonionic contrast media: a report from the Japanese Committee on the Safety of Contrast Media. Radiology 1990; 175: 621PubMed

30.

Adkinson FN. Drug allergy. In: Middleton E, Reed C, Ellis EF, et al., editors. Allergy principlesand practice. St Louis: Mosby, 1998: 1217

31.

Adkinson NF. Beta-lactam crossreactivity. Clin Exp Allergy 1998; 28(4) 37–40PubMed

32.

Craig TJ, Mende C. Common allergic and allergic-like reactions to medications. Postgrad Med 1999 Mar; 105(3): 173–81PubMedCrossRef

33.

Sogn DD, Evans III R, Shepard GM, et al. Results of the National Institutes of Allergy and Infectious Diseases Collaborative Clinical Trial to test the predictive value of skin testing with major and minor penicillin derviatives in hospitalized adults. Arch Intern Med 1992; 152: 1025–32PubMedCrossRef

34.

Pichichero ME, Pichichero DM. Diagnosis of penicillin, amoxicillin and cephalosporin allergy: reliability of examination assessed by skin testing and oral challenge. J Pediatr 1998 Jan; 132: 137–43PubMedCrossRef

35.

Vervloet D, Arnaud A, Vellieux P, et al. Anaphylactic reactions to muscle relaxants under general anesthesia. J Allergy Clin Immunol 1979; 63: 348PubMedCrossRef

36.

Lieberman P. Difficult allergic drug reactions. Immunol Allergy ClinNorthAm 1991; 11(1): 331

37.

Wolkenstein P, Revuz J. Drug-induced severe skin reactions. Drug Safety 1995; 13(1): 56–68PubMedCrossRef

38.

Gleckman RA, Borrego F. Adverse reactions to antibiotics. Postgrad Med 1997 Apr; 101(4) 97–108PubMedCrossRef

39.

Valyasevi MA, Van Dellen RG. Frequency of systematic reactions to penicillin skin tests. Ann Allergy Asthma Immunol 2000 Nov; 85(5): 363–5PubMedCrossRef

40.

Gruchalla R. Understanding drug allergies. J Allergy Clin Immunol 2000; 105: 637–44CrossRef

41.

Solley GO, Gleich GJ, Van Dellen RG. Penicillin allergy: clinical experience with a battery of skin-test reagents. J Allergy Clin Immunol 1982; 69: 238–44PubMedCrossRef

42.

Gadde J, Spence M, Wheeler B, Adkinson NF. Clinical experience with penicillin skin testing in a large inner city STD clinic. JAMA 1993; 270: 2456–63PubMedCrossRef

43.

Li JTC, Markus PJ, Osmon DR, et al. Reduction of vancomycin use in orthopedic patients with a history of antibiotic allergy. Mayo Clin Proc 2000; 75: 902–6PubMedCrossRef

44.

Parker DJ, Parrinello JT, Condemi JJ, et al. Penicillin resensitization among hospitalized patients. J Allergy Clin Immunol 1991; 88: 213–7PubMedCrossRef

45.

Simons PR, Roberts JR, Gu X, et al. Epinephrine absorption in children with history of anaphylaxis. J Allergy Clin Immunol 1998; 101: 33–7PubMedCrossRef

46.

Mayumi H, Kimura S, Asano M, et al. Intravenous cimetidine as an effective treatment for systemic anaphylaxis and acute allergic skin reaction. Ann Allergy 1987; 58: 447–50PubMed

Titel: Preventing and Managing Drug-Induced Anaphylaxis
verfasst von: Kerry L. Drain
Dr Gerald W. Volcheck
Publikationsdatum: 01.09.2001
Verlag: Springer International Publishing
Erschienen in: Drug Safety / Ausgabe 11/2001
Print ISSN: 0114-5916
Elektronische ISSN: 1179-1942
DOI: https://doi.org/10.2165/00002018-200124110-00005

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Preventing and Managing Drug-Induced Anaphylaxis

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2001

Parenteral Drug Administration Errors by Nursing Staff on an Acute Medical Admissions Ward During Day Duty

Increased Risk of Somnolence with the New Dopamine Agonists in Patients with Parkinson’s Disease

Nitric Oxide—Releasing NSAIDs

Causality Assessment of Adverse Effects

The Use of Analgesics in Patients with Asthma

A Risk-Benefit Assessment of Treatments for Infantile Spasms