Heparins allergy

The benefit and necessity of adding heparin to PN are unclear. There are also concerns about the stability/compatibility of intravenous lipid emulsions with heparin added at concentrations above 1 unit/mL. Heparin should be omitted in patients with active bleeding, thrombocytopenia, heparin-induced thrombocytopenia (HIT), or heparin allergy. 

Heparin allergy, which caused a pruritic urticaria-like rash on the back in a 55-year-old man, without associated angioedema, wheezing, flushing, or anaphylaxis, has been successfully managed with an intravenous desensitization protocol (Table 1) [124 ]. Two earher protocols, which were used in a 34-year-old man [125 ] and a 55 year-old woman [126 ], are also shown in Table 1 for comparison. An even faster protocol has also been described [127 ]. A combined subcutaneous and intravenous protocol that was used in a 55-year-old woman is shown in Table 2 [128 ]. 

Parekh K, Burkhart HM, Hatab A, Ross A, Muller BA. Heparin allergy successful desensitization for cardiopulmonary bypass. J Thorac Cardiovasc Surg 2005 130(5) 1455-6. 

Hypersensitivity reactions Heparin is derived from animal tissue use with caution in patients with a history of allergy. Before a therapeutic dose is given, a trial dose may be advisable. Have epinephrine 1 1000 immediately available. 

The following patient categories were excluded from the study patients with ostial and bifurcation lesions, left ventricular ejection fraction <30%, known hypersensitivity or contraindication to aspirin or stainless steel, or a sensitivity to contrast dye, allergy to heparin or ticlopidine,... 

Before starting any procedure needing local anesthesia, ask the patient if he or she has any allergies to anesthetics.Also inquire if the patient is on any anticoagulant medications (e g., aspirin, Coumadin, and heparin) that could create bleeding problems. 

In some cases of allergy to a heparin formulation, the precipitating agent will prove to be a preservative, such as chlorocresol (93) or chlorbutol (94), rather than heparin itself. 

Berkun Y, Haviv YS, Schwartz LB, Shaht M. Heparin-induced recurrent anaphylaxis. Qin Exp Allergy 2004 34(12) 1916-18. 

Contraindications Allergy to heparin uncontrolled bleeding Allergy to heparin. Awid in patients with CrQ of < 30 ml/ min. Use in caution in patients with low body weights. Pregnancy hemorrhagic tendencies... 

The PMN cells include neutrophils, eosinophils, and basophils. Neutrophils make up 60-75% of circulating WBCs and provide the first line of defense against microbes that penetrate the normal barriers of skin. They are extremely efficient phagocytes and are a source of inflammatory cytokines and lipid mediators such as PGs, LTs, and platelet-activating factor. Eosinophils are involved in allergy and provide protection against parasites. Basophils contain vasoactive amines such as histamine, serotonin, and heparin, as well as precursors for PGs and LTs. Release of these pharmacological materials by the basophils is responsible for the anaphylactic reaction. These factors also serve as chemoattractants for neutrophils and eosinophils to sites of inflammation. 

This was chosen as the first clinical problem to be studied since it presents visible lesions produced by mixtures of inflammation, allergy, and infection, all of which should release histamine. The alkaline antibiotics neomycin, streptomycin, polymyxin, and viomycin were combined with heparin because they could then produce the double-barreled action of an antibiotic complex with the antiinflammatory action of binding the endogeneously released histamine. It is further believed that by releasing the antibiotic slowly, toxic levels might be avoided in the plateau of release. 

The therapeutic effect of heparin has also been studied by others in allergies, infections, inflammations, and conditions with unknown etiologies. 

Yes. Allergies to meat derived from certain animals may precipitate allergic reactions to heparin derived from the same source (e.g., beef or pork). In addition, allergies to sulfites may precipitate allergic reactions to heparin that is administered as sulfur conjugates. 

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