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
Anaphylaxis spares no drug: A report of diclofenac-induced anaphylaxis mimicking post-laparoscopy respiratory complication.
Saudi journal of anaesthesia 2023;17;236-238 — 2023 — 236-238
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
Cause and Clinical Presentation of Anaphylaxis in Singapore: From Infancy to Old Age.
International archives of allergy and immunology 2018;175;91-98 — 2018 — 91-98
Nonsteroidal anti-inflammatory drugs are major causes of drug-induced anaphylaxis.
The journal of allergy and clinical immunology. In practice 2014 Jul-Aug;2;414-20 — 2014 Jul-Aug — 414-20
Anaphylaxis: incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan.
QJM : monthly journal of the Association of Physicians 2013 Dec;106;1095-101 — 2013 Dec — 1095-101
Brown SG, Stone SF, Fatovich DM, Burrows SA, Holdgate A, Celenza A, Coulson A, Hartnett L, Nagree Y, Cotterell C, Isbister GK
Anaphylaxis: clinical patterns, mediator release, and severity.
The Journal of allergy and clinical immunology 2013 Nov;132;1141-1149.e5 — 2013 Nov — 1141-1149.e5
Severe drug-induced anaphylaxis: analysis of 333 cases recorded by the Allergy Vigilance Network from 2002 to 2010.
Allergy 2013 Jul;68;929-37 — 2013 Jul — 929-37
Anaphylaxis in Latin American children and adolescents: the Online Latin American Survey on Anaphylaxis (OLASA).
Allergologia et immunopathologia 2012 Nov-Dec;40;331-5 — 2012 Nov-Dec — 331-5
Anaphylaxis: a review of 601 cases.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2006 Jul;97;39-43 — 2006 Jul — 39-43
Quiralte J, Delgado J, Sáenz de San Pedro B, López-Pascual E, Nieto MA, Ortega N, Florido JF, Conde J
Safety of the new selective cyclooxygenase type 2 inhibitors rofecoxib and celecoxib in patients with anaphylactoid reactions to nonsteroidal anti-inflammatory drugs.
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2004 Oct;93;360-4 — 2004 Oct — 360-4
Anaphylaxis: risk factors for recurrence.
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2003 Aug;33;1033-40 — 2003 Aug — 1033-40
Hypersensitivity to pyrazolones.
Thorax 2000 Oct;55 Suppl 2;S72-4 — 2000 Oct — S72-4
Anaphylaxis. A review of 266 cases.
Archives of internal medicine 1995 Sep 11;155;1749-54 — 1995 Sep 11 — 1749-54