Anaphylactic shock General

The penicillins in general, ate renowned for their lack of toxicity. The most common adverse effect of the use of penicillins is an allergic reaction which can change from a mild rash to fatal anaphylactic shock in rate cases. AH penicillins cross the placenta and ate excreted in maternal milk. However, the relative freedom from toxicity tenders these compounds valuable agents during pregnancy and lactation. 

The most serious acute Type I reaction is the generalized reaction, the anaphylactic shock. Anaphylactic shock results from a generalized release of mediators from mast cells and basophils. The clinical symptoms are manifested predominantly in... 

The term anaphylactic shock describes a severe generalized type I allergic reaction associated with cardiovascular shock, airway constriction and heart arrhythmias, which, if left untreated, may cause death. 

Dybendal X Guttormsen AB, Elsayed S, Askeland 48 B, Harboe T, Florvaag E Screening for mast cell tryptase and serum IgE antibodies in 18 patients with anaphylactic shock during general anaesthesia. 

As a bacterial protein, streptokinase is viewed by the human immune system as an antigenic substance. In some cases, its administration has elicited allergic responses that have ranged from mild rashes to more serious anaphylactic shock (an extreme and generalized allergic response characterized by swelling, constriction of the bronchioles, circulatory collapse and heart failure). 

Other reactions are of the tuberculin granulomatous type or of the local vasculitis Arthus type. The local reactions can be accompanied, preceded, or followed by a generalized reaction, such as urticaria, nausea, vomiting, diarrhea, angioedema, wheezing, or anaphylactic shock. The last of these is rare, but sometimes fatal. 

While the pattern of alclofenac toxicity resembles that of other NSAIDs, the frequency of adverse effects differs widely. Allergic reactions have been reported more frequently and skin rashes have been particularly common. Hypersensitivity reactions, including anaphylactic shock, severe generalized vasculitis, hepatotoxicity, and nephrotoxicity, have been observed. Alclofenac has therefore been withdrawn in several countries (1). Blood dyscrasias and neurological symptoms are rare. 

Cell therapy consists of the parenteral or enteral administration of cells or parts of cell obtained from animal organs and/or tissues from cattle, sheep, pigs, or rabbits. Two different types of cell preparations are in use fresh cells, which are administered in fresh form, and dried cells or so-called sicca cells, which are prepared for later use. The most prevailing risks of cell therapy are local and generalized allergic reactions (fever, nausea, vomiting, urticaria, and anaphylactic shock). Other untoward consequences include fatal and non-fatal encephalomyelitis, polyneuritis, Landry-Guillain-Barre sjmdrome, fatal serum sickness, perivenous leukoencephalitis, and immune-complex vasculitis. 

Generalized hypersensitivity reactions and anaphylactic shock can occur but are infrequent. H5rpersensitivity reactions to deferoxamine may require permanent withdrawal, worsening the prognosis in thalassemia. However, successful desensitization has been achieved in three patients with previous deferoxamine hypersensitivity, enabling continued administration of deferoxamine (8,114,115). 

Ingestion of psyUinm has been associated with rare cases of generalized nrticarial rash and anaphylactic shock (5,6). The possibility that the intestinal absorption of lithinm and other dmgs may be inhibited by psyUinm shonld also be considered (7). 

Metamizole was the single most commonly used agent causing adverse reactions (mainly hypersensitivity reactions, anaphylactic shock, and two deaths) in India, based on reports to an adverse drug reactions monitoring center by general practitioners (SEDA-16,108). 

In nearly half of the cases, the course of anaphylactic shock, especially that induced by penicillin and other small molecular substances, is that of a cardiovascular reaction without any other effects suggestive of an allergic mechanism (173-175). There is an extensive list of articles on anaphylactic shock to penicillins (7-10,173,174,176,177). General anesthesia does not inhibit the development of anaphylactic shock in penicillin allergy (178). 

Generalized seizures or twitching of the limbs have been observed in children and adults (210,212-216). As a rule, the symptoms abate and disappear within several minutes to an hour. They rarely persist for up to 24 hours. If a cardiovascular reaction with a fall in blood pressure occurs simultaneously with typical symptoms, a combination with anaphylactic shock must be considered (217,218). 

Severe adverse drug reactions with trimethoprim and co-trimoxazole are rare (12-14). This also applies to children (15). The adverse effects of co-trimoxazole correspond to those expected from a sulfonamide (16). In HIV-infected patients, adverse effects of co-trimox-azole are more frequent and more severe (17-19). Hematological disturbances due to co-trimoxazole include mild anemia, leukopenia, and thrombocytopenia, which may be due to folic acid antagonism. Serious metabolic disturbances that are associated with trimethoprim include hyperkalemia and metabolic acidosis. Trimethoprim can cause hypersensitivity reactions. However, with co-trimoxazole, the sulfonamide is generally believed to be more allergenic (12). Generalized skin reactions predominate. Other effects, such as anaphylactic shock, are extremely rare (20-22). Carcinogenicity due to trimethoprim or co-trimoxazole has not been reported. 

Adverse effects, in general, are low. However, all penicillins have the potential for causing interstitial nephritis (of allergic origin), and serious allergic reactions resulting in urticaria progressing to anaphylactic shock. 

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