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
Immediate and delayed hypersensitivity to systemic corticosteroids: 2 case reports.
Dermatitis : contact, atopic, occupational, drug 2012 Nov-Dec;23;288-90 — 2012 Nov-Dec — 288-90
Anaphylaxis induced by glucocorticoids.
The Journal of the American Board of Family Practice 2005 Mar-Apr;18;143-6 — 2005 Mar-Apr — 143-6
Nakamura H, Matsuse H, Obase Y, Mitsuta K, Tomari S, Saeki S, Kawano T, Kondo Y, Machida I, Shimoda T, Asai S, Kohno S
Clinical evaluation of anaphylactic reactions to intravenous corticosteroids in adult asthmatics.
Respiration; international review of thoracic diseases 2002;69;309-13 — 2002 — 309-13
[Severe anaphylactoid reactions after intravenous corticosteroids. Report of a case and review of the literature].
Therapie 1990 Nov-Dec;45;505-8 — 1990 Nov-Dec — 505-8
Systemic allergic reactions to corticosteroids.
The Journal of asthma : official journal of the Association for the Care of Asthma 1991;28;329-39 — 1991 — 329-39