What are
the medications most often implicated in anaphylaxis? In anaphylactoid
reactions?
Anaphylaxis is commonly caused by antibiotics
(pre-dominantly the β-lactam antibiotics, which account for about
75% of anaphylaxis in the United States), radiology contrast dye, and
protamine. The rate of anaphylactic reac-tions with iodinated contrast has
significantly decreased because sensitive individuals are being pretreated with
steroids and antihistamines, and non-ionic contrast with less potential to
cause allergic reactions is being used. Latex has emerged as a cause of
anaphylactic reaction (as well as other allergic reactions), probably because
of the increas-ing use of latex gloves and barriers. Patients with spina
bifida, patients who have undergone multiple surgeries, and healthcare workers
are especially at risk.
Anaphylactoid reactions are commonly caused by
mor-phine, d-tubocurarine, certain antibiotics (e.g., vancomycin,
ciprofloxacin), aspirin (possibly through inhibition of cyclo-oxygenase), and
succinylcholine. While not causing hista-mine release per se, β-blockers have been found to increase the incidence of
anaphylactoid reactions.
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