Drug anaphylaxis

Another way to classify anaphylactic reactions regards the eliciting agents the most common elicitors of anaphylaxis are drugs, insect venoms, foods, additives,... 

Harmaway PJ, Hoppler GDK Severe anaphylaxis and drug induced p-blockage. N Engl J Med 1983 308 1536. 

The Australian study identified drugs as the most common cause of anaphylaxis fatalities [22]. Of 105 non-food-induced anaphylaxis cases, 64 were drug-induced. Most deaths occurred in adults 55 to >85 years of age with similar numbers of male and female subjects [22]. 

There were a total of 3,019 drug-induced anaphylaxis hospital admissions between 1998 and 2005 reported from Australia [22]. Again, in prepuberty cases, males were more frequently affected and females outnumbered male subjects in the age groups >15 years. The age-specific hospitalization rates were highest for... 

The role of atopy among drug-induced anaphylaxis depends probably on the elici-tating drug here clearly more data are needed. 

Anaphylaxis that is IgE-dependent is most commonly associated with reactions to foods, drugs, and insect venoms. Anaphylactic-like reactions that are not dependent... 

Insect venoms, together with foods and drugs, are the most frequent elicitors of anaphylaxis in men. The insect venom is applied by stings which must have occurred for more than 100,000 years, since human beings exist. Conflicts between stinging insects and humans occur while fighting for food, like honey or foods consumed outdoors, or while venomous insects feel threatened by human beings, most often near their nests. 

While in anaphylaxis caused by other frequent elicitors like food and drugs, allergen-specific immunotherapy is not established, immimotherapy with Hymenoptera venoms has been shown to be effective in three prospective controlled trials (table 4) [38-40] and also in a number of studies where patients were submitted to a sting challenge with the responsible insect during venom immimotherapy (table 5) [44]. While over 90% of vespid venom-allergic patients are fully protected and do not develop any... 

They differ to some extent from signs and symptoms that occur during anaphylaxis not associated with anesthesia. Early subjective symptoms such as malaise, pruritus, sensation of heat, and dizziness are absent in the anesthetized patient. Cutaneous signs in a completely wrapped patient may escape the attention of the anesthetist. The increase in heart rate, a decrease in blood pressure and an increase in airway resistance may be initially misinterpreted as a result of a pharmacological dose-related effect of the drugs, or of excessively light anesthesia. Many differential diagnoses have to be considered (table 1). 

In 15-50% of cases, IgE-mediated anaphylaxis to a NMBA has been reported at the first known contact with a NMBA [1,3, 14]. This suggests a possible cross-reaction with IgE antibodies generated by previous contact with apparently unrelated chemicals drugs, such as pholcodine, cosmetics, disinfectants and industrial materials [14,... 

Among the antianaphylactic drugs, epinephrine (adrenaline) is the essential substance. In the acute treatment of the anaphylaxis in addition to the classical ABC (airway, breathing, circulation) rule for cardiopulmonary resuscitation [26, 27], one can apply the AAC rule (antigen off, adrenaline, cortisone) [18], Other drugs playing a role in the treatment of anaphylaxis include antihistamines (Hi-antagonists). 

Gu X, Simons KJ, Simons FER Administration by sublingual tablet feasible for the first aid treatment of anaphylaxis A proof-of-concept study. Diophar Drug Dispos 2002 23 213-216. 

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