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… 
Multiple drug allergies: Recommendations for perioperative management.
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The process of expert allergy testing following a suspected case of anaphylaxis to guide future safe anesthesia administration and the pathophysiology of hypersensitivity reactions and the implications for anesthesia of food allergy, atopy, and family history of allergy in children are reviewed.
No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut†.
TLDR
The present practice of choosing alternatives to propofol in patients with this kind of food allergy is not evidence based and should be reconsidered.
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TLDR
A case of anaphylactic reaction to rocuronium in a male patient confirmed as having multiple cross-reactivity to various neuromuscular blocking agents (NMBAs) on an allergic skin test at three months after discharge is reported on.
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TLDR
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Since anaphylaxis presents with significant hypovolemia and vasoplegia, aggressive fluid therapy and epinephrine are the cornerstones of management.
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