Anaphylactic shock drugs involved

L-Tyrosine metabolism and catecholamine biosynthesis occur laigely in the brain, central nervous tissue, and endocrine system, which have large pools of L-ascorbic acid (128). Catecholamine, a neurotransmitter, is the precursor in the formation of dopamine, which is converted to noradrenaline and adrenaline. The precise role of ascorbic acid has not been completely understood. Ascorbic acid has important biochemical functions with various hydroxylase enzymes in steroid, dmg, andUpid metabolism. The cytochrome P-450 oxidase catalyzes the conversion of cholesterol to bile acids and the detoxification process of aromatic drugs and other xenobiotics, eg, carcinogens, poUutants, and pesticides, in the body (129). The effects of L-ascorbic acid on histamine metabolism related to scurvy and anaphylactic shock have been investigated (130). Another ceUular reaction involving ascorbic acid is the conversion of folate to tetrahydrofolate. Ascorbic acid has many biochemical functions which affect the immune system of the body (131). 

Co-administration of beta-blockers has been associated with an increased risk of severe allergic drug reactions and reduces the effect of adrenaline in the immediate treatment of anaphylactic shock. The mechanism involves changes in the regulation of anaphylactic mediators (281). 

The main systems affected by adverse effects of the quinolones are the skin, liver, and nervous system. The best-known adverse effect is phototoxicity, the risk of which varies markedly among the quinolones lomefloxacin and sparfloxacin carry a particularly high risk. The development of phototoxicity is based on an interaction between hght and the drug. Neurotoxicity also occurs, with marked variation of incidence between the various compounds. Hypersensitivity reactions to quinolones are rare, and include anaphylactic shock and anaphylactoid reactions. Organ-specific reactions attributed to hypersensitivity involve the liver and kidneys. If hypersensitivity reactions occur, switching from one qui-nolone compound to another is probably not advisable, since there is cross-reactivity. 

Laxenaire MC, Moneret-Vautrin DA, Gueant JL, et al. Drugs and other agents involved in anaphylactic shock occurring during anaesthesia. A French multicenter epidemiological inquiry. Ann Fr Anesth Reanim 1993 12(2) 91-6. 

In another survey conducted by the clinical section of the British Pharmacological Society over a one-year period from 1986 to 1987, 8163 healthy volunteers received drugs for research purposes.Potentially life-threatening adverse effects were reported in 0-04% and moderately severe adverse effects in 0-55%, with no lasting sequelae. The three severe reactions were skin irritation and rash requiring hospitalisation, anaphylactic shock after an oral vaccine, and perforation of a duodenal ulcer after multiple-dose non-steroidal anti-inflammatory drug all made a complete recovery. The results were similar to those reported in the earlier ABPI survey and the authors concluded that the risk involved in these studies is very small... 

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