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1.
Masui ; 59(6): 788-91, 2010 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-20560391

RESUMO

A 71-year-old woman was scheduled for revision of total hip replacement under general anesthesia. Twenty minutes before entering the operating room, slight urticaria was caused by drop infusion of cefotiam. It was stopped immediately and the patient entered the operating room without any symptoms. Anesthesia was induced and maintained with sevoflurane and remifentanil. After 3 hours, systolic arterial pressure (SAS) dropped to 80 mmHg. Injecting of ephedrine 8 mg was not effective, and we injected a total of 3 mg of methoxamine. Then SAS dropped to 50 mmHg. We injected epinephrine 0.2 mg twice and also started continuous infusion of norepinephrine. Severe skin rash indicated that anaphylactic reaction had occurred. About 20 minutes after starting norepinephrine, the SAS was stabilized. We decided to stop the operation, and the patient was moved to the intensive care unit (ICU). A few hours after entering the ICU, she was extubated and moved to the general ward next day. Skin-prick-tests performed 14 days later indicated that she was allergic to ephedrine, methoxamine, epinephrine, dopamine and a few more drugs.


Assuntos
Anafilaxia/induzido quimicamente , Complicações Intraoperatórias/induzido quimicamente , Testes Cutâneos , Vasoconstritores/imunologia , Idoso , Anestesia Geral , Artroplastia de Quadril , Dopamina/imunologia , Efedrina/imunologia , Epinefrina/imunologia , Feminino , Humanos , Metoxamina/imunologia , Reoperação , Índice de Gravidade de Doença
2.
Am J Clin Dermatol ; 5(5): 351-5, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15554736

RESUMO

INTRODUCTION: Sympathomimetic (alpha-adrenergic) drugs are mainly used because of their vasoconstrictor properties, for nasal congestion, or as mydriatics. Although sympathomimetic drugs are used often, allergic reactions are rare, especially when the drugs are administered systemically. Cross-reactivity may exist among catecholamine derivatives, although reported data on this are contradictory. In this study, we investigate if there is cross-reactivity in patch tests among these drugs. MATERIAL AND METHODS: Patch tests with 10% phenylephrine and 10% pseudoephedrine in petrolatum, and 10% and 20% ephedrine, 10% phenylpropanolamine, 5% fepradinol, 1% methoxamine, and 10% oxymetazoline, all administered in dimethyl sulfoxide (DMSO), were carried out in 14 patients with a history of allergy to any of these drugs. DMSO was used as the negative control. RESULTS: All patients except one (patient number five) showed positive patch-test reactions to at least two different drugs. Nine patients (64.3%) were cross-sensitized to three or more different drugs, and 57.1% of patients were sensitized to four or more sympathomimetic drugs. Patients who experienced generalized rashes caused by orally administered pseudoephedrine had a stronger response and more cross-reactivity with other sympathomimetic drugs in patch tests than those who experienced local contact dermatitis. CONCLUSIONS: We conclude that there is cross-reactivity among the different sympathomimetic drugs tested, especially if the drug is administered systemically.


Assuntos
Alérgenos/imunologia , Conjuntivite Alérgica/imunologia , Dermatite Alérgica de Contato/imunologia , Midriáticos/imunologia , Testes do Emplastro , Simpatomiméticos/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alérgenos/efeitos adversos , Reações Cruzadas , Dimetil Sulfóxido , Efedrina/imunologia , Etanolaminas/imunologia , Feminino , Humanos , Masculino , Metoxamina/imunologia , Pessoa de Meia-Idade , Midriáticos/efeitos adversos , Oximetazolina/imunologia , Testes do Emplastro/métodos , Fenilefrina/imunologia , Fenilpropanolamina/imunologia , Método Simples-Cego , Simpatomiméticos/efeitos adversos , Fatores de Tempo
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