Abstract
Among the major etiological factors that can cause an anaphylactic shock (AS), drugs account for 31.2-46.5%. Purpose of the work was to identify factors associated with a high AS risk based on 2010-2018 records made in the Republic of Crimea. Materials and methods. The objects of the study were 112 information reports about adverse reactions (AR) to medicine remedies (MR), which were recorded in the regional database of spontaneous information reports—ARCAD — in the Republic of Crimea during 2010-2018. A retrospective analysis of drug-induced AS cases has been carried out for the following indicators: intake and route of administration of drugs, gender, age, history of allergies. Results of the study have shown that antimicrobial drugs, local anesthetics, analgesics-antipyretics, X-ray contrast iodine-containing substances, and non-steroidal anti-inflammatory drugs featured the highest AS incidence. Most frequently, AS cases were observed in patients aged 31 to 60 years, with no significant differences between men (57 cases) and women (54 cases). In one case the patient's gender was missed or not stated. The leader in AS incidence is Ceftriaxone, which application was associated with 22 cases of such AR. In 87 cases, AS was found associated with parenteral administration drugs, the intravenous route of administration being predominant (44 cases). In 97 cases, development of drug-induced AS was life-threatening and required emergency pharmacotherapy; 8 reports contained a lethal outcome record. Conclusions. Attention should be paid to high incidence, severity, and instant progression rate of adverse reactions in the form of AS. Considering the AS progression rate and facts of ignored past history of drugs and allergies, as well as pharmacological correction errors, additional educational events are worth conducting for physicians specializing in different fields.
Highlights
Anaphylactic shock (AS) is one of the most dangerous complications of drug therapy [1, 2]
Attention should be paid to high incidence, severity, and instant progression rate of adverse reactions in the form of AS
Considering the AS progression rate and facts of ignored past history of drugs and allergies, as well as pharmacological correction errors, additional educational events are worth conducting for physicians specializing in different fields
Summary
Anaphylactic shock (AS) is one of the most dangerous complications of drug therapy [1, 2]. According to WHO, it is rather difficult to establish anaphylactic shock prevalence because of differences in AS diagnosing and coding between countries worldwide, and impossibility of undertaking prospective cohort studies to investigate it. The average overall prevalence of AS is 80–120 cases per million person-years, and the total mortality reaches 1% (the mortality rate of 1–5.5 per million population per year) [2]. The main groups of drugs capable of causing anaphylaxis are X-ray contrast aids, antibacterial drugs, local anesthetics, and narcosis aids [3, 5, 9]. The cases of AS developed in the course of skin tests or allergenspecific immunotherapy occur much rarer
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