![]() ![]() There was no evidence of associations between use of beta-blockers, ACEI's, ARA's, TCA's, MAOI's or NSAID's and moderate (adjusted relative risk (aRR) 1.0, 95% CI 0.42-2.37) or severe anaphylaxis (aRR 1.41, 95% CI 0.47-4.16).ĭespite concerns regarding detrimental effects of certain medications on anaphylaxis severity, our findings suggest that beta-blockers, ACEI's, ARA's, TCA's, MAOI's or NSAID's were not associated with increased severity of anaphylaxis. At least one dose of epinephrine was administered in 71.2% (95% CI 66.8-75.3) of presentations and 2.5% (95% CI 1.4-4.4) required hospital admission. ![]() Food was the trigger in 53.3% (95% confidence intervals (CI) 48.7-59.0) of presentations and exposure medications were regularly used by 15.7% (95% CI 12.6-19.4). Ten (2.3%) presented with more than one episode of anaphylaxis. Multivariable logistic regression was used to examine relationships between the above medications and severity of anaphylaxis in adults, including adjustment for potential confounding.īetween October 2011 and June 2018, 432 adults of whom 40% were male, with a median age of 39 years (interquartile range 26.8-52.8) presented to the ED with anaphylaxis. Anaphylaxis severity was defined as mild, moderate or severe according to the position paper of the European Academy of Allergology and Clinical Immunology on management of anaphylaxis in childhood. The exposure was regular use of beta-blockers, ACEI's, ARA's, TCA's, MAOI's or NSAID's. Physicians completed questionnaires recording clinical symptoms, co-morbidities and regular use of medications among anaphylaxis cases in adults older than eighteen years of age presenting to ED's in five Canadian tertiary hospitals. The aim of this study was to examine whether regular use of cardiac or psychiatric medications or NSAID's in adults was associated with an increased risk of severe anaphylaxis. Several classes of prescribed medications are suggested to increase the risk of severe anaphylaxis including cardiac medications, specifically beta-blockers, angiotensin converting enzyme inhibitors (ACEI's) and angiotensin receptor antagonists (ARA's) psychiatric medications, specifically tricyclic antidepressants (TCA's) and monoamine oxidase inhibitors (MAOI's), and non-steroidal anti-inflammatory drugs (NSAID's). The prevalence of Emergency Department (ED) visits for anaphylaxis has increased recently. Molloy JD 1, Clarke A 2, Morris J 3, Lim R 4, Ben-Shoshan M 1ġMcGill University Health Centre, Montreal, Canada 2University of Calgary, Calgary, Canada 3Sacré-Coeur Hôpital, Montreal, Canada 4Children's Hospital at London Health Science Centre, London, Canada ANAPHYLAXIS AND PERIOPERATIVE HYPERSENSITIVITY PD0204 | Prescribed medications as risk factors for severe anaphylaxis ![]()
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