ABSTRACT
Intradermal testing and RIA testing for specific IgE antibodies to neuromuscular blocking drugs (NMBDs) were performed in patients referred to an Anaesthetic Allergy Clinic. Six patients were initially investigated four to 29 years after clinical anaphylaxis during anaesthesia and two of these patients and sixteen others were investigated by intradermal testing on two occasions at least four years apart. Seven patients had RIA tests for NMBD-specific IgE antibodies on two occasions at the time of skin testing. In all but two patients the evidence for drug-specific antibodies persisted 4-29 years after the reactions. In one patient all tests became negative and in another the skin test became negative but the positive RIA persisted. Evidence of antibodies to NMBDs persisted in 21 of 22 patients who had had anaphylactic reactions to these drugs during anaesthesia. In the absence of evidence of allergy diminishing with time in the majority of patients it would seem wise to avoid drugs responsible for reactions for the rest of the patient's life.
Subject(s)
Drug Hypersensitivity/diagnosis , Neuromuscular Blocking Agents/adverse effects , Alcuronium/adverse effects , Alcuronium/analysis , Anaphylaxis/diagnosis , Anaphylaxis/metabolism , Antibodies/analysis , Decamethonium Compounds/adverse effects , Decamethonium Compounds/analysis , Drug Hypersensitivity/metabolism , Gallamine Triethiodide/adverse effects , Gallamine Triethiodide/analysis , Humans , Immunoglobulin E/analysis , Neuromuscular Blocking Agents/analysis , Radioimmunoassay , Skin Tests , Succinylcholine/adverse effects , Succinylcholine/analysis , Time Factors , Tubocurarine/adverse effects , Tubocurarine/analysisABSTRACT
I. I. Mechnikov Kharkov Research Institute of Microbiology, Vaccines and Sera, Ministry of Public Health of the Ukrainian SSR. The results of mass spectrometric investigation of decamethoxine++, an antimicrobial chemotherapeutic drug, are presented. It was shown that desorption-field mass spectrometry provided recording decamethoxine++ intensive quasimolecular ions [M.Cl]+ and [M]++ forming under conditions of high electric intensity only from the intact parent molecule. Hence, the presence of the peaks in the desorption field mass spectra made it possible to definitively determine decamethoxine++ in the samples. Therefore, the procedure of desorption-field mass spectrometry proved reliable in identification of bisquaternary ammonium compounds. Ways for thermal decomposition and mass spectrometric fragmentation of the decamethoxine++ molecule under various ionization conditions are also discussed.
