Increased risk for anaphylactoid reaction from contrast media in patients on beta-adrenergic blockers or with asthma

Article Abstract:

Certain X-ray studies require the use of intravenous contrast media; these substances show up on an X-ray and help outline the organ being studied. However, contrast agents provoke significant allergic reactions in one to two percent of the patients who receive them, and are responsible for approximately 500 deaths each year. Newer contrast agents that do not provoke as many allergic reactions have been developed, but their costs are exorbitant. Therefore, it is desirable to identify patients who are at risk for such allergic reactions and who should be considered as candidates for the newer, more expensive contrast agents. People who have experienced previous allergic reactions are known to be at greater risk of further allergic reactions. Some studies have suggested that patients who have asthma may be at greater risk, and additional reports have noted that patients who are taking drugs in the category known as beta-blockers experience allergic reactions to contrast media. A study was done of nearly 29,000 patients who underwent X-ray studies requiring the use of contrast media. Anaphylactoid (allergic) reactions were observed in 63 of these patients. Asthma or the use of beta-blockers was found in 39 percent of the reactors, but only 16 percent of the nonreactors. Of the five patients whose anaphylactoid reactions were severe enough to warrant hospitalization, three were taking beta-blockers and one was an asthmatic. One interesting observation of this study is the fact that two-thirds of the reactors were women. This finding requires further investigation, as not all studies of anaphylactoid reactions from contrast media show a sex difference. When X-ray studies using contrast media are necessary in people who have asthma or who are taking beta-blockers, use of the newer, more expensive agents is probably indicated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Asthma, Adrenergic beta blockers, Adrenergic beta-antagonists, Anaphylaxis, Contrast media, Contrast media (Chemicals)

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Anaphylactoid reactions reported after treatment with ciprofloxacin

Article Abstract:

Reporting of side effects by physicians is a routine but invaluable means of learning about patients' responses to prescription drugs. A review of 262 cases involving the antibacterial drug ciprofloxacin revealed that, in addition to the more common side effects, 15 patients had anaphylactoid reaction. This "allergic" reaction was defined as consisting of at least two of the following symptoms, which could be accounted for by no other disease: hypotension or shock; respiratory dysfunction such as apnea (temporary cessation of breathing), asthma, or edema (swelling); or urticaria (hives) or angioedema (swelling associated with blood vessels). There were no fatalities among the patients suffering such anaphylactoid reactions. Of the 15 patients, 14 had reactions upon receiving their first dose, suggesting that cross-reacting antibodies from some other source may have been already in their blood. Since not all adverse reactions are reported, anaphylactoid reactions to ciprofloxacin may be more common than the 5.7 percent indicated by these data. (Consumer Summary produced by Reliance Medical Information, Inc.)

Quinolones, Ciprofloxacin

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Collateral damage

Article Abstract:

Antibiotics not only kill dangerous bacteria but also bacteria that are important to the proper functioning of the body. Many bacteria that normally live in the human gastrointestinal tract help the body metabolize food. Patients should never be given antibiotics for long periods of time to minimize the adverse impact on the beneficial bacteria in the gastrointestinal tract.

Editorial, Drug resistance in microorganisms, Microbial drug resistance

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