Potential anaphylactoid reaction to nicardipine.

Autor: Hassan AM; Department of Emergency Medicine St. Elizabeth Hospital Boardman Ohio USA., Hill H; Department of Emergency Medicine St. Elizabeth Hospital Youngstown Ohio USA., Donley C; Department of Emergency Medicine St. Elizabeth Hospital Youngstown Ohio USA., Leonelli C; Department of Pharmacy St. Elizabeth Hospital Youngstown Ohio USA.
Jazyk: angličtina
Zdroj: Journal of the American College of Emergency Physicians open [J Am Coll Emerg Physicians Open] 2024 Aug 12; Vol. 5 (4), pp. e13271. Date of Electronic Publication: 2024 Aug 12 (Print Publication: 2024).
DOI: 10.1002/emp2.13271
Abstrakt: Anaphylactic and anaphylactoid reactions are both acute allergic responses known to be potentially fatal if not treated emergently. Signs include bronchospasm, urticaria, nausea and vomiting, pharyngeal edema and cardiovascular collapse. Nicardipine hydrochloride is a dihydropyridine calcium channel blocker that has emerged as a first-line antihypertensive in which emergent blood pressure control is critical. The patient in this case is a 52-year-old male who arrived at the emergency department (ED) with right-sided hemineglect, severe dysarthria, and aphasia, and he was diagnosed with an acute left thalamic hemorrhage. His blood pressure readings were initially 252/135 mmHg despite multiple intermittent boluses of intravenous hydralazine. He was administered a nicardipine hydrochloride infusion at 2.5 mg/h. Due to poor blood pressure control, the rate was titrated up in increments of 2.5 mg/h in the span of 30 min. While up titrating the infusion rate, he developed diffuse swelling and erythema to his left upper extremity in which the medication was being infused, a body wide urticarial rash, tachycardia, diaphoresis, wheezing, and hypoxemia saturating 85% on room air.
(© 2024 The Author(s). Journal of the American College of Emergency Physicians Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)
Databáze: MEDLINE
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