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The Drug-Induced Respiratory Disease Website

An absolute emergency. Anaphylaxis and  anaphylactoid reactions (Review at PMID 28800865). Drug-induced anaphylaxis can be fatal (PMID 25280385). Drugs (NSAIDs, antibiotics, RCM) are foremost as a cause of anaphylaxis (PMID: 25553259). Expression is more severe and treatment more difficult in patients who were receiving beta-blockers prior to the episode (PMID 6114116, 6146275). Angioedema, bronchospasm, shock common. Consider i.m. epinephrine and liberal fluid administration quickly. See also under shock (XIIn ) and PMID 17378256 & 22467837. Anaphylaxis and anaphylactoid reactions usually develop unexpectedly. Can be severe and/or prolonged. Fatal in about 2%. Clinically, anaphylaxis is a systemic reaction with flushing, cramping, shock, laryngeal edema, bronchospasm, pulmonary edema, arrhythmia, cardiac arrest, empty vena cava syndrome, and/or the locked lung. Can lead to death within minutes from angioedema, bronchospasm, cardiac arrest and/or pulmonary edema (PMID: 16916722, 22467837). Rechallenge with the drug must be avoided. See also under IVb, VIIIa and b and X. Guidelines at PMID 15753926. Reviews, epidemiologic surveys at PMID 10823122, 12733472, 15073989, 16916722, 1789822,19217731, 19901808, 22987983, 22467837, 23741979, 24881890, 25538414, 28611774, 29950872. Operative anaphylaxis is a severe form of anaphylaxis: PMID 19143700, 24251246, 22467837. All drugs that cause anaphylaxis may not be listed here. Guidelines, see also under PMID 24909803 and http://publications.nice.org.uk/anaphylaxis-assessment-to-confirm-an-anaphylactic-episode-and-the-decision-to-refer-after-emergency-cg134/introduction. A series of DI anaphylaxis with >1000 cases has been published in 2017 (PMID 29086147). Rechallenge with the drug must be avoided (PMID 28611774).

Publications

Pouessel G, Tacquard C, Tanno LK, Mertes PM, Lezmi G

Anaphylaxis mortality in the perioperative setting: Epidemiology, elicitors, risk factors and knowledge gaps.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2024 Jan;54;11-20 — 2024 Jan — 11-20

Dhopeshwarkar N, Sheikh A, Doan R, Topaz M, Bates DW, Blumenthal KG, Zhou L

Drug-Induced Anaphylaxis Documented in Electronic Health Records.

The journal of allergy and clinical immunology. In practice 2019 Jan;7;103-111 — 2019 Jan — 103-111

Koplin JJ, Martin PE, Allen KJ

An update on epidemiology of anaphylaxis in children and adults.

Current opinion in allergy and clinical immunology 2011 Oct;11;492-6 — 2011 Oct — 492-6

Gruchalla RS, Pirmohamed M

Clinical practice. Antibiotic allergy.

The New England journal of medicine 2006 Feb 09;354;601-9 — 2006 Feb 09 — 601-9

Leone R, Conforti A, Venegoni M, Motola D, Moretti U, Meneghelli I, Cocci A, Sangiorgi Cellini G, Scotto S, Montanaro N, Velo G

Drug-induced anaphylaxis : case/non-case study based on an italian pharmacovigilance database.

Drug safety 2005;28;547-56 — 2005 — 547-56

MINOZZI A

[On the pathogenesis of hemorrhagic phenomena during anaphylactic shock from penicillin].

Minerva medica 1959 Oct 31;50;3482-9 — 1959 Oct 31 — 3482-9

JAMES LP, AUSTEN KF

FATAL SYSTEMIC ANAPHYLAXIS IN MAN.

The New England journal of medicine 1964 Mar 19;270;597-603 — 1964 Mar 19 — 597-603

SPAULDING WB

Dangers in the use of some potent drugs.

Canadian Medical Association journal 1962 Dec 15;87;1275-81 — 1962 Dec 15 — 1275-81

ETTER RL, MERRYMAN G

Anaphylactic shock and death due to penicillin; report of a case.

Annals of allergy 1954 Jul-Aug;12;453-4 — 1954 Jul-Aug — 453-4

CURPHEY JT

Fatal anaphylaxis in bronchial asthma following administration of penicillin; report of two cases with autopsy findings.

New York state journal of medicine 1953 May 01;53;1107-10 — 1953 May 01 — 1107-10

Risk of anaphylaxis in a hospital population in relation to the use of various drugs: an international study.

Pharmacoepidemiology and drug safety 2003 Apr-May;12;195-202 — 2003 Apr-May — 195-202

Xi-Moy S, Thorvilson NK, Edmiston CE, Woehlck HJ

Anaphylaxis to penicillin on reperfusion during liver transplantation.

Anesthesiology 2000 Jul;93;280-1 — 2000 Jul — 280-1

Dunn AB, Blomquist J, Khouzami V

Anaphylaxis in labor secondary to prophylaxis against group B Streptococcus. A case report.

The Journal of reproductive medicine 1999 Apr;44;381-4 — 1999 Apr — 381-4

Cullen DJ

Severe anaphylactic reaction to penicillin during halothane anaesthesia. A case report.

British journal of anaesthesia 1971 Apr;43;410-2 — 1971 Apr — 410-2