Resolving the Histamine-Releasing and Allergenic Effects in Diagnosing Reactions to Opioid Drugs

6 Resolving the Histamine-Releasing and Allergenic Effects in Diagnosing Reactions to Opioid Drugs 

In reviewing the published findings on adverse reactions induced by all the opioid analgesics implicated so far, it is clear that the key to distin- 

Drug Symptoms Diagnostic tests employed Test results Authors diagnosis Retrospective assessment of diagnosis and comments 

Morphine 0.3 mg/kg IV at 10 mg/min Hypotension, tachycardia, flushing IDT with morphine (0.35x10-2 2 cm wheal Anaphylactoid reaction. Direct effect of morphine. Type 1 reaction unlikely Anaphylactoid reaction. No evidence of immune-mediated reaction 

Morphine 10 mg bolus IV i BP, t HR, tachycardia Tryptase test Positive Anaphylaxis Possibly anaphylaxis but confirmatory tests lacking 

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