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The Drug-Induced Respiratory Disease Website

Philippe Camus, M.D.

Dijon, France

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General anesthesia

3

X.f Anaphylaxis-Anaphylactoid reaction (can be fatal)

2
Last update : 25/03/2014
 
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Identify causative drugs
Diagnosing DIRD
1
Drug and radiation history
2
Drug singularity - Correct identification of the drug
3
Consistent timing of exposure v. onset of symptoms
4
Clinical, imaging, BAL, pathological pattern consistent with the specific drug
5
Careful exlusion of another cause
6
Remission of symptoms with removal of drug
7
Recurrence with rechallenge (rarely advisable)
8
Causality assessment
More detailed checklist
See also under
Colloids
2
Crystalloids
1
Dyes
3
Ethosuximide
2
Ethylene-vinyl alcohol copolymer (e.g. Onyx (R))
1
Fentanyl
5
Fluorescein
1
Forceful inspiration against a closed glottis or airway
4
Fresh frozen plasma
2
Gases
5
Gelatin
1
Hemotherapy (transfusion/infusion of whole blood, red cells, platelets, or blood products)
5
Heparin
4
Inhalants (volatile substances)
5
Ketamine
2
Lepirudin
1
Lipiodol - Iodinated/iodized oil (RCM)
2
Liposuction
3
Macro-aggregated albumin (& 99Tc tagged)
1
Methacrylate - Methylmethacrylate
2
Methylene blue
1
Microspheres
1
Morphine
5
Neuromuscular blocking agents (NMBA-NMBD)
5
Nitric oxide (NO)
4
Nitrites - Nitrates (oral - inhaled ('Poppers'))
3
Opiates - Opioids - Opium
5
Oxygen (dioxygen, O2)
4
Pancuronium
1
Patent blue
2
Plasma
2
Pulmonary hypertension therapy
2
Sevoflurane
2
Sufentanil
2
Sugammadex
1
Thiopental
2
Thrombolytic (fibrinolytic) agents
3
Transhepatic arterial chemoembolization (TACE)
3
Vertebroplasty (kyphoplasty)
4

Publications

Suspected recurrent anaphylaxis in different forms during general anesthesia.
Journal of anesthesia 2010 Feb;24;143-5 2010 Feb

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