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
Jingo K, Harada N, Nishioki T, Torasawa M, Yamada T, Asao T, Takagi H, Takeshige T, Ito J, Takahashi K
Anaphylaxis to three humanized antibodies for severe asthma: a case study.
Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology 2020;16;46 — 2020 — 46
American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology Omalizumab-Associated Anaphylaxis Joint Task Force follow-up report.
The Journal of allergy and clinical immunology 2011 Jul;128;210-2 — 2011 Jul — 210-2
Omalizumab: Practical considerations regarding the risk of anaphylaxis.
Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology 2010 Dec 03;6;32 — 2010 Dec 03 — 32
Omalizumab-associated anaphylactic reactions reported between January 2007 and June 2008.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2009 Nov;103;442-5 — 2009 Nov — 442-5
The use of omalizumab in the treatment of severe allergic asthma: A clinical experience update.
Respiratory medicine 2009 Aug;103;1098-113 — 2009 Aug — 1098-113
Delayed onset and protracted progression of anaphylaxis after omalizumab administration in patients with asthma.
The Journal of allergy and clinical immunology 2007 Dec;120;1378-81 — 2007 Dec — 1378-81
Systemic reaction to omalizumab.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2006 Aug;97;267 — 2006 Aug — 267
Characterization of an anaphylactoid reaction to omalizumab.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2006 Apr;96;624-7 — 2006 Apr — 624-7