An Allergic Reaction Following Intramuscular Administration of Ketamine and Midazolam

Boynes, Sean G.; Lemak, Anne L.; Skradski, Denise M; Cuddy, Michael A.

doi:10.17796/jcpd.31.2.6q619k3664634250

Cited by 14 publications

(10 citation statements)

References 16 publications

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“…Allergic reactions to ketamine have been described in three reports. They are all pediatric cases ranging from rashes to anaphylaxis (8,9,11). The first patient, a 3-year old child, developed an extensive macular rash attributed to the direct pharmacological effect of the drug rather than an allergy (8).…”

Section: Discussionmentioning

confidence: 99%

Midazolam and Ketamine Hypersensitivity in a Four Year Old Child

Ayyıldız¹,

Sözmen²,

Tezcan³

et al. 2017

Asthma Allergy Immunol

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ÖZÇocuklarda anestezi sırasında görülen hipersensitivite reaksiyonları erişkinlere göre daha nadirdir. Nöromusküler bloke edici ajanlar hem erişkinlerde hem de çocuklarda anestezi sırasında en sık duyarlılık saptanan ajanlardır ve antibiyotik duyarlılığı bu ajanları takip etmektedir. Benzodiazepinler ve ketamin genellikle allerjinin çok da sık görülmediği ajanlar olarak bilinirler. Yazıda anestezi sırasında ürtikeryal lezyonları ortaya çıkan ve tanısal testler yapıldığında hem midazolam hem de ketamine duyarlılık saptanan 4 yaşında bir çocuk hasta sunulmuştur. ABSTRACTHypersensitivity reactions during anesthesia are rarer in childhood when compared with adults. In both children and adults, neuromuscular blocking agents are the most frequently incriminated drugs in this setting followed by antibiotics. Benzodiazepines and ketamine are generally regarded as exceptional drugs regarding allergy. In this report, we present a 4-year old child who developed urticarial lesions during anesthesia and was found to have hypersensitivity to both midazolam and ketamine when diagnostic tests were performed.Anahtar kelimeler: Ürtiker, anestezi, midazolam ketamin, hipersensitivite

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Section: Discussionmentioning

confidence: 99%

Midazolam and Ketamine Hypersensitivity in a Four Year Old Child

Ayyıldız¹,

Sözmen²,

Tezcan³

et al. 2017

Asthma Allergy Immunol

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“…Intradermal tests revealed an allergic reaction to ketamine. Boynes et al [122] reported an urticarial response in a 6-year-old girl following the intramuscular administration of ketamine and midazolam. Further skin testing confirmed a positive reaction to ketamine.…”

Section: Ketaminementioning

confidence: 99%

Allergy to illicit drugs and narcotics

Swerts

Gasse

Leysen

et al. 2014

Clin Experimental Allergy

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Despite their frequent use, allergy to illicit drugs and narcotics is rarely reported in literature. We present a review of the different classes of drugs of abuse that might be involved in allergies: central nervous system (CNS) depressants (such as cannabis, opioids and kava), CNS stimulants (cocaine, amphetamines, khat and ephedra) and hallucinogens such as ketamine and nutmeg. Diagnosis of drug and narcotic allergy generally relies upon careful history taking, complemented with skin testing eventually along with quantification of sIgE. However, for various reasons, correct diagnosis of most of these drug allergies is not straightforward. For example, the native plant material applied for skin testing and sIgE antibody tests might harbour irrelevant IgE-binding structures that hamper correct diagnosis. Diagnosis might also be hampered due to uncertainties associated with the non-specific histamine releasing characteristics of some compounds and absence of validated sIgE tests. Whether the introduction of standardized allergen components and more functional tests, that is, basophil activation and degranulation assays, might be helpful to an improved diagnosis needs to be established. It is anticipated that due to the rare character of these allergies further validation is although necessary.

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“…Immediate hypersensitivity reaction to ketamine is rare, and despite the drug's long history and widespread use, case reports in the literature are scant . Ketamine reaction with an associated rise in serum tryptase has not been previously reported.…”

Section: Introductionmentioning

confidence: 99%

Immunoglobulin E‐Mediated Hypersensitivity Reaction to Ketamine

2016

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This case represents a likely immunoglobulin E-mediated type I hypersensitivity reaction to ketamine, supported by elevated tryptase levels and positive intradermal skin testing. The interpretation of these results and likely mechanism of the hypersensitivity reaction are described. The patient and treating team were advised against subsequent use of ketamine, due to the risk of serious adverse systemic reaction with repeat exposure.

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An Allergic Reaction Following Intramuscular Administration of Ketamine and Midazolam

Cited by 14 publications

References 16 publications

Midazolam and Ketamine Hypersensitivity in a Four Year Old Child

Midazolam and Ketamine Hypersensitivity in a Four Year Old Child

Allergy to illicit drugs and narcotics

Immunoglobulin E‐Mediated Hypersensitivity Reaction to Ketamine

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