Anesthesia in the patient with multiple drug allergies: are all allergies the same?

@article{Dewachter2011AnesthesiaIT,
  title={Anesthesia in the patient with multiple drug allergies: are all allergies the same?},
  author={Pascale Dewachter and Claudie Mouton-Faivre and Mariana C. Castells and David L. Hepner},
  journal={Current Opinion in Anaesthesiology},
  year={2011},
  volume={24},
  pages={320–325}
}
Purpose of review During the preoperative evaluation, patients frequently indicate ‘multiple drug allergies’, most of which have not been validated. Potential allergic cross-reactivity between drugs and foods is frequently considered as a risk factor for perioperative hypersensitivity. The aim of this review is to facilitate the recognition of risk factors for perioperative anaphylaxis and help the management of patients with ‘multiple drug allergies’ during the perioperative period. Recent… Expand
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References

SHOWING 1-10 OF 43 REFERENCES
My patient is allergic to eggs, can i use propofol? A case report and review
TLDR
It is concluded that anaesthetists should be alerted when using prop ofol in patients with history of atopy or several drug allergies, and current evidence suggests that egg allergic patients are not more likely to develop anaphylaxis when exposed to propofol. Expand
Use of propofol in patients with food allergies
TLDR
The negligible protein content of refined soya oil in propofol suggests the drug is unlikely to trigger a reaction in patients with peanut allergy, and if the clinician decides prop ofol is unsuitable, inhalational induction of anaesthesia may provide a useful alternative. Expand
What investigation after an anaphylactic reaction during anaesthesia?
TLDR
The scope of this review is to focus on the allergological assessment required to prove the immune mechanism, to identify the culprit drug or substance and the cross-reactive molecules, especially for neuromuscular blocking agents, allowing preventive measures for future anaesthetic procedures. Expand
Possible Anaphylaxis after Propofol in a Child with Food Allergy
TLDR
Propofol should be avoided in patients with allergies to egg and/or soybean oil, if possible, and Clinicians should consider the potential for adverse drug events in Patients with select food allergies. Expand
[Value of skin tests for the choice of a neuromuscular blocking agent after an anaphylactic reaction].
TLDR
The authors underline the value of a detailed allergological assessment to identify the pathophysiologic mechanism, the culprit drug and to propose a safer alternate drug that might be used. Expand
Anaphylaxis and Anesthesia: Controversies and New Insights
TLDR
The clinical diagnostic pathway necessary to distinguish anaphylaxis from confounding clinical diagnoses is identified and new therapeutic perspectives for the management of patients whose hemodynamic collapse is unresponsive to catecholamines, the initial recommended pharmacologic intervention are discussed. Expand
Egg allergy in childhood: an update
  • D. Tey, R. Heine
  • Medicine
  • Current opinion in allergy and clinical immunology
  • 2009
TLDR
Despite recent advances in oral immunotherapy trials, the treatment of egg allergy currently relies on avoidance of egg-containing foods until tolerance has developed, and it remains unclear whether the ongoing low-dose exposure to egg proteins in cooked foods improves the natural history of egg allergies. Expand
Pholcodine exposure raises serum IgE in patients with previous anaphylaxis to neuromuscular blocking agents
TLDR
The present study explores the effect of pholcodine exposure on IgE in a population with previously diagnosed IgE‐mediated anaphylaxis towards NMBAs. Expand
British Society for Allergy and Clinical Immunology guidelines for the management of egg allergy
  • A. Clark, I. Skypala, +5 authors S. Nasser
  • Medicine
  • Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
  • 2010
TLDR
All children with egg allergy should receive measles, mumps and rubella (MMR) vaccination and Influenza and yellow fever vaccines should only be considered in egg‐allergic patients under the guidance of an allergy specialist. Expand
Anaphylaxis During Cardiac Surgery: Implications for Clinicians
TLDR
Recent concepts in understanding the incidence and management approaches for patients at risk for anaphylaxis in the operating room setting are focused on, with an emphasis on cardiac surgical patients. Expand
...
1
2
3
4
5
...