Urticaria heparins

Other adverse reactions include local irritation when heparin is given via the SC route. Hypersensitivity reactions may also occur with any route of administration and include fever, chills, and urticaria. More serious hypersensitivity reactions include an astiima-like reaction and an anaphylactoid reaction. 

Type I IgE Anaphylaxis, urticaria P-Lactam antibiotics penicillins (primarily), cephalosporins, carbapenems Non-fl-lactam antibiotics sulfonamides, vancomycin Others insulin, heparin... 

Adverse reactions associated with heparin include hemorrhage, chills, fever, urticaria, and thrombocytopenia. 

A wide range of allergic reactions have been described in patients receiving heparin, including urticaria, conjunctivitis, rhinitis, asthma, cyanosis, tachjrpnea, a feeling of oppression, fever, chUls, angioedema, and anaphylactic shock. 

As a result of the inhibitory effect of heparin on antibodies and anaphylaxis, allergic reactions are infrequent and true heparin sensitivity rare (one case of anaphylactic shock). Urticaria has been seen, induced by sensitivity to heparin s animal protein, and a histamine-like response at the injection site which gradually disappears if injections are maintained. 

Clemastine Fumarafe (Tavist, Dayhist, Antihist-1) [OTC] [Antihistamine] Uses Allergic rhinitis Sxs of urticaria Action Antihistamine Dose Adults Peds. >12 y 1.34 mg bid to 2.68 mg dd max 8.04 mg/d <6 y 0.335-0.67 mg/d into (max 1.34 mg/d) 2-3 d. 6-12 y 0.67-1.34 mg bid (max 4.02 /d) Caution [C, M] BOO do not take w/ MAOI Contra NAG Disp Tabs, syrup SE Drowsiness, dyscoordinadon, epigastric distress, urinary retendon Interactions T Effects V/ CNS depressants, MAOIs, EtOH i effects OF heparin, sulfonylureas EMS Use odier CNS depressants w/ caudon concuirent EtOH use can T CNS effects T risk of photosensidvity Rxns OD May cause CNS... 

Danaparoid and hirudins are chemically distinct from heparin and generally show little or no cross-reactivity in heparin-intolerant patients. Reported reactions to danaparoid include rash, pruritus, and reactions (some delayed) at the injection site. Figures of 0.015 and 0.16 % have been reported for anaphylaxis to hirudins on first and subsequent exposures, respectively. Urticaria and angioedema are other reported type I reactions. Fondaparinux selectively inhibits coagulation factor Xa and has a low allergenic potential. 

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 ]. 

Weber HO, Fischer J, Kneilling M, Caroli U, Rocken M, Biedermann T. Recall urticaria induced by skin tests with heparin. Br J Dermatol 2009 161(1) 187-9. 

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