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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425305 | PMC |
| http://dx.doi.org/10.4103/0019-5049.98799 | DOI Listing |
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Culprit allergen prevalence in polyreactive individuals reflects prescription trends: A tool for estimating comparative anaphylaxis risk using the example of neuromuscular blocking agents.
Anaesth Intensive Care
January 2025
Department of Anaesthesia, Sir Charles Gairdner Hospital, Nedlands, Australia.
Prescription-event monitoring (PEM) is the current gold standard for determining the risk of rare drug side-effects and comparing the risk between agents; however, spontaneous or prompted reporting schemes have low case-detection rates and exposure may be difficult to estimate. A novel method is described that allows a comparative adverse event rate between two drugs to be estimated-based on patterns of cross-reactivity-requiring only a sample of cases and no direct knowledge of drug exposure rates. Agreement was compared between the novel method and historical estimates of risk using PEM for comparative risk of rocuronium versus vecuronium anaphylaxis.
View Article and Find Full Text PDFAdverse events related to neuromuscular blocking agents: a disproportionality analysis of the FDA adverse event reporting system.
Front Pharmacol
July 2024
Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Article Synopsis
- Neuromuscular blocking agents (NMBAs) are used during surgeries to assist with intubation and improve operating conditions, but their safety was the focus of this study.
- The research analyzed data from the FDA's adverse event reporting system, looking at four specific NMBAs (atracurium, cisatracurium, rocuronium, and vecuronium) over almost two decades.
- Findings revealed a total of 11,518 adverse events associated with these drugs, with significant signals related to various serious health issues, including cardiac and respiratory disorders, and identified new adverse events like ventricular fibrillation and Kounis syndrome.
Allergic Reactions to Sugammadex: A Case Series and Review of the Literature.
J Pediatr Pharmacol Ther
August 2023
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital and The Ohio State University, Columbus, OH.
Sugammadex is a novel agent for the reversal of neuromuscular blockade; it acts by encapsulating -rocuronium or vecuronium, eliminating the active compound from the circulation, thereby providing rapid and complete recovery even with profound or complete neuromuscular blockade. Clinical advantages, including reduced incidence of residual blockade, decreased nausea and vomiting, decreased dry mouth, less change in heart rate, and reduced pulmonary complications, have been demonstrated when comparing sugammadex to conventional agents, such as neostigmine, that inhibit acetylcholinesterase. Although generally safe and effective, anaphylactoid and allergic reactions have been reported with sugammadex.
View Article and Find Full Text PDFAnaphylaxis under anesthesia is a rare but potentially severe disease. Although anaphylaxis is rare, it can be lethal if not diagnosed and treated appropriately. We present the case of a 43-year-old male with no prior allergy history who experienced a severe anaphylactic reaction that resulted in cardiac arrest after the intravenous injection of vecuronium.
View Article and Find Full Text PDFNeuromuscular blocking agent re-exposure in a retrospective cohort with neuromuscular blocking agent-associated anaphylaxis.
Ann Allergy Asthma Immunol
November 2023
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Drug Safety Center, Seoul National University Hospital, Seoul, Republic of Korea; Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address:
Background: Neuromuscular blocking agents (NMBAs) are one of the most common causes of perioperative anaphylaxis. Although skin test positivity may help identify reactive NMBAs, it is unclear whether skin test negativity can guarantee the safety of systemically administered NMBAs.
Objective: This study aimed to evaluate the real-world safety of alternative NMBAs screened using skin tests in patients with suspected NMBA-induced anaphylaxis.
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