Acute anaphylactic reactions

Fisher, M. McD.; Baldo, Brian A.

doi:10.5694/j.1326-5377.1988.tb120481.x

Cited by 28 publications

(20 citation statements)

References 22 publications

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“…für die Narkose verwendet werden, ist außerordentlich vielfältig und umfaßt Pruritus, Urtikaria mit oder ohne Schleimhautbeteiligung (bis hin zur anaphylaktischen Reaktion), makulopapulöse oder lichenoide Exantheme, Erythema multiforme-ähnliche oder auch fixe Arzneimittelexantheme u.a. [18]. Es gibt weitere Überempfindlichkeitsreaktionen auf Narkotika ohne nennenswerte Hauterscheinungen, die sich z.B.…”

Section: Pathophysiologie Medikamentös-induzierter Narkosezwischenfälleunclassified

Allergien und pseudoallergische Reaktionen auf Narkosemittel

Rosenberger¹,

Treudler²,

Blume‐Peytavi³

et al. 1997

Der Hautarzt

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Nearly all drugs currently used during the course of general anaesthesia may lead to hypersensitivity reactions of various types. There may be an acute type I allergic reactions or to a more or less severe pseudo-allergic reactions, in rare cases with lethal outcome. Routine preoperative testing appears of little predictive value, in spite of the high frequency of so-called risk factors (atopy, other kind of allergy) among the evaluated group of patients. Careful allergological testing should be performed 4 to 6 weeks after any incidents of suspected drug intolerance, in order to discover the underlying causative agent. Skin testing is of diagnostic value for neuromuscular blockers and intravenous narcotics. RAST- and RIA-tests and/or mediator releasing tests may also used additionally. Together with all other administered drugs, all the routinely used neuromuscular blockers (suxamethonium, vecuronium, pancuronium, alcuronium, atracurium, mivacurium) should be tested, since they often represent the cause for such reactions. For other classes of drugs (for example, volatile anesthetics and opioids) the clinical relevance of skin testing still remains uncertain. For less severe incidents seen during general anaesthesia such as pruritus, or exanthema, skin testing seems to be less relevant.

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Section: Pathophysiologie Medikamentös-induzierter Narkosezwischenfälleunclassified

Allergien und pseudoallergische Reaktionen auf Narkosemittel

Rosenberger¹,

Treudler²,

Blume‐Peytavi³

et al. 1997

Der Hautarzt

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“…Cardiovascular collapse is common in severe anaphylaxis.1 22 Arrhythmias, hypovolaemia, decreased myocardial 93 …”

Section: Cardiovascular Responsesmentioning

confidence: 99%

“…In particular, antihistamines and steroids should never be relied upon alone as first-line therapy.' 22 There is conflicting and inconclusive data with regard to the use of antihistamines in anaphylaxis. On the basis of an extensive review of current data, Lieberman concluded that for the prevention of drug-induced anaphylactic and anaphylactoid reactions, combined Hi and H2 receptor blockade is more effective than Hi blockade alone.63…”

Section: Use Of Antihistaminesmentioning

confidence: 99%

Anaphylactic shock: mechanisms and treatment.

Brown

1995

Emergency Medicine Journal

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SUMMARYThis paper reviews the mechanisms of anaphylactic shock in terms of the immunoglobulin and non-immunoglobulin triggering events, and the cellular events based on the rise in intracellular cyclic AMP and calcium that release preformed granule-associated mediators and the rapidly formed, newly synthesized mediators predominantly based on arachidonic acid metabolism. These primary mediators recruit other cells with the release of secondary mediators that either potentiate or ultimately curtail the anaphylactic reaction. The roles of these mediators in the various causes of cardiovascular collapse are examined. The treatment of anaphylactic shock involves oxygen, adrenaline and fluids. The importance and safety of intravenous adrenaline are discussed.Combined Hi and H blocking antihistamines and steroids have a limited role. Glucagon and other adrenergic drugs are occasionally used, and several new experimental drugs are being developed.

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“…However, fatal reactions have occurred without elevation of plasma histamine suggesting other equally important mediators are involved. Mast cells and circulating basophils are the key cells in the allergic response, and produce two main groups of mediators following triggering 22 .…”

Section: Mechanisms Of Anaphylactic Shockmentioning

confidence: 99%

“…The final consideration in discussing mechanisms of anaphylactic shock is the cardiovascular response in humans to the primary and secondary mediators previously mentioned. Cardiovascular collapse is common in severe anaphylaxis 1,22 . Arrhythmias, hypovolemia, decreased myocardial contractility and pulmonary hypertension all contribute 29 .…”

Section: Mechanisms Of Anaphylactic Shockmentioning

confidence: 99%

Anaphylactic shock: mechanisms and treatment

Brown¹

1994

Emergency Medicine

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This paper reviews the mechanisms of anaphylactic shock in terms of the immunoglobulin and non‐immunoglobulin triggering events; and the cellular events based on the rise in intracellular cyclic AMP and calcium that release preformed granule associated mediators and the rapidly formed, newly synthesised mediators predominantly based on arachidonic acid metabolism. These primary mediators recruit other cells with the release of secondary mediators that either potentiate or ultimately curtail the anaphylactic reaction. The roles of these mediators in the various causes of cardiovascular collapse are examined. The treatment of anaphylactic shock involves oxygen, adrenaline and fluids. The importance and safety of intravenous adrenaline are discussed. Combined H1 and H2 blocking antihistamines and steroids have a limited role. Glucagon and other adrenergic drugs are occasionally used, and there are several new experimental drugs.

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Acute anaphylactic reactions

Cited by 28 publications

References 22 publications

Allergien und pseudoallergische Reaktionen auf Narkosemittel

Allergien und pseudoallergische Reaktionen auf Narkosemittel

Anaphylactic shock: mechanisms and treatment.

Anaphylactic shock: mechanisms and treatment

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