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- Patients with any cephalosporin allergy have 25% cross-reactivity with penicillins
- Patients with a true allergy to penicillin have ~2% cross-reactivity with cephalosporins
- Patients with cephalosporin allergy CAN be on a carbapenem
- Patients with true allergy to penicillin, cross-reactivity with carbapenems is <10%, so do a test dose in the hospital if starting a carbapenem
Posted 07/18/16 10:22:09 AM by Anna Krigel
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- Sensitization stage - formation of drug specific IgE by drug-protein complex cross-linking with immunoglobulin surface receptors on B cells
- Effector/Re-exposure stage - sensitized individual is re-exposed to the medication, drug cross-links with drug-specific IgE on the surface of mast cells and/or basophils, resulting in sudden and widespread release of vasoactive mediators
Posted 07/18/16 10:47:29 AM by Anna Krigel
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Anaphylaxis
- High output failure similar to sepsis
- With allergic reaction, first figure out if it is anaphylaxis or not
- about 1/4 will recur or present 5 hours after drug exposure as a late phase response to the allergic reaction
- can present with abdominal cramping
Posted 07/18/16 10:52:23 AM by Anna Krigel
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Anaphylaxis management
- EPINEPHRINE! - dose is 0.3-0.5mg of 1:1,000 concentration given intramuscularly, can be repeated every 5-15 minutes up to 3-4 doses
- IV fluids - to combat the massive capillary leak
- antihistamines - inhibit mediator release from mast cells/basophils, provides symptomatic relief
- corticosteroids - no immediate effects, used to prevent/mitigate potential delayed reaction
Posted 07/18/16 11:01:29 AM by Anna Krigel
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For further reading...
Posted 07/18/16 11:03:33 AM by Anna Krigel
Created by Christopher Kelly
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.