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2017 ; 173
(1
): 51-60
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the
Beijing Pharmacovigilance Database
#MMPMID28505618
Wang T
; Ma X
; Xing Y
; Sun S
; Zhang H
; Stürmer T
; Wang B
; Li X
; Tang H
; Jiao L
; Zhai S
Int Arch Allergy Immunol
2017[]; 173
(1
): 51-60
PMID28505618
show ga
BACKGROUND: Few studies assessing the use of epinephrine in drug-induced
anaphylaxis (DIA) in the hospital setting are available. We utilized the Beijing
Pharmacovigilance Database (BPD) to evaluate the appropriateness of epinephrine
for DIA management. METHODS: DIA cases collected in the BPD from January 2004 to
December 2014 were adjudicated and analyzed for demographics, causative drugs,
clinical signs, outcomes, initial treatment, route, dosing, and cardiovascular
adverse events (CAE) of epinephrine. RESULTS: DIA was primarily caused by
antibiotics (38.4%), radiocontrast agents (11.9%), traditional Chinese medicine
injections (10.9%), and chemotherapeutic drugs (10.3%). Only 708 (59.5%) patients
received epinephrine treatment. Patients who received epinephrine were more
likely to experience wheezing (p < 0.001) and respiratory arrest (p < 0.001).
Among 518 patients with a complete record of the epinephrine administration
route, the percentage of patients receiving it by intramuscular (IM) injection,
subcutaneous (SC) injection, intravenous (IV) bolus injection, or IV continuous
infusion was 16.9, 31.5, 43.5, and 8.1%, respectively. Among the 427 patients
with a record of both the administration route and the dosing, an overdose was
more likely with IV bolus (94.1%) in contrast to IM injection (56.6%; p < 0.001)
or SC injection (43.7%; p < 0.001). Among the patients analyzed for CAE (n =
349), 17 patients accounted for 19 CAE, and 13 (76.5%) of these patients were
overdosed with epinephrine. CONCLUSION: Underuse, inappropriate IV bolus use, and
overdosing were the 3 major problems with epinephrine use in DIA in China.
Educational training for health care professionals on the appropriate use of
epinephrine in managing anaphylactic reactions is suggested.
|Adult
[MESH]
|Aged
[MESH]
|Anaphylaxis/*drug therapy
[MESH]
|Beijing
[MESH]
|Bronchodilator Agents/administration & dosage/adverse effects/*therapeutic use
[MESH]