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
COVID-19 vaccines: anaphylaxis and anxiety : A case study from an allergy unit.
Wiener klinische Wochenschrift 2024 Nov;136;590-597 — 2024 Nov — 590-597
Luxi N, Giovanazzi A, Arcolaci A, Bonadonna P, Crivellaro MA, Cutroneo PM, Ferrajolo C, Furci F, Guidolin L, Moretti U, Olivieri E, Petrelli G, Zanoni G, Senna G, Trifirò G
Allergic Reactions to COVID-19 Vaccines: Risk Factors, Frequency, Mechanisms and Management.
BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy 2022 Jul;36;443-458 — 2022 Jul — 443-458
A Case Report of Prolonged Anaphylaxis after COVID-19 Vaccine.
Clinical practice and cases in emergency medicine 2022 Feb;6;21-24 — 2022 Feb — 21-24
Biphasic anaphylaxis after first dose of messenger RNA coronavirus disease 2019 vaccine with positive polysorbate 80 skin testing result.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2021 Jul 31;; — 2021 Jul 31
Anaphylaxis and Coronavirus Disease 2019 vaccine: a danger relationship?
Current opinion in allergy and clinical immunology 2021 Jul 30;; — 2021 Jul 30
COVID-19 vaccine anaphylaxis: PEG or not?
Allergy 2021 06;76;1934-1937 — 2021 06 — 1934-1937
Anaphylaxis is a rare reaction in COVID-19 vaccination.
Journal of biological regulators and homeostatic agents 2021 Jun 09;35; — 2021 Jun 09
Sampath V, Rabinowitz G, Shah M, Jain S, Diamant Z, Jesenak M, Rabin R, Vieths S, Agache I, Akdis M, Barber D, Breiteneder H, Chinthrajah S, Chivato T, Collins W, Eiwegger T, Fast K, Fokkens W, O'Hehir RE, Ollert M, O'Mahony L, Palomares O, Pfaar O, Riggi
Vaccines and Allergic reactions: the past, the current COVID-19 pandemic, and future perspectives.
Allergy 2021 Apr 02;; — 2021 Apr 02
Bousquet J, Agache I, Blain H, Jutel M, Ventura MT, Worm M, Del Giacco S, Benetos A, Bilo MB, Czarlewski W, Abdul Latiff AH, Al-Ahmad M, Angier E, Annesi-Maesano I, Atanaskovic-Markovic M, Bachert C, Barbaud A, Bedbrook A, Bennoor KS, Berghea EC, Bindslev
Management of anaphylaxis due to COVID-19 vaccines in the elderly.
Allergy 2021 Apr 02;; — 2021 Apr 02
Allergic reactions to the first COVID-19 vaccine: A potential role of polyethylene glycol?
Allergy 2021 06;76;1617-1618 — 2021 06 — 1617-1618