Toogood J H
CMAJ. 1987 May 1;136(9):929-33.
Beta-blocker therapy is associated with an increase in the severity and, possibly, the incidence of acute anaphylaxis. The population at risk consists of people with allergic conditions who are given a beta-blocker for an unrelated condition. Anaphylaxis under these conditions may be severe, protracted and resistant to conventional treatment because of the beta-adrenergic blockade. Severe or fatal attacks have been triggered by insect stings, the ingestion of allergenic foods or drugs, and injections of radiocontrast media, antisera or immunotherapy antigens. These occurrences are probably infrequent, but their incidence is unknown. At least two fatal cases have recently occurred in Canada. Clinical allergists, internists and family practitioners in particular should be aware of the need for aggressive and prolonged support in patients who experience anaphylaxis while receiving beta-blocker therapy and should report all such occurrences to the federal registry of adverse drug reactions. Allergy skin testing or immunotherapy is inadvisable in patients who take a beta-blocker orally or in the form of ophthalmic eyedrops. The list of relative contraindications to beta-blocker use should be extended to include susceptibility to recurrent anaphylaxis, whether it is idiopathic or due to an identifiable cause.
β受体阻滞剂治疗与急性过敏反应的严重程度增加以及可能的发生率增加有关。高危人群包括患有过敏性疾病但因无关病症而服用β受体阻滞剂的人。在这些情况下，由于β肾上腺素能阻滞，过敏反应可能很严重、持续时间长且对传统治疗有抵抗性。昆虫叮咬、摄入致敏食物或药物以及注射放射性造影剂、抗血清或免疫治疗抗原都可能引发严重或致命的发作。这些情况可能很少见，但其发生率尚不清楚。加拿大最近至少发生了两起致命病例。临床过敏症专科医生、内科医生和家庭医生尤其应意识到，对于在接受β受体阻滞剂治疗时发生过敏反应的患者，需要积极和长期的支持，并应向联邦药物不良反应登记处报告所有此类事件。对于口服β受体阻滞剂或以眼药水形式使用β受体阻滞剂的患者，不建议进行过敏皮肤试验或免疫治疗。β受体阻滞剂使用的相对禁忌清单应扩大到包括复发性过敏反应的易感性，无论其是特发性的还是由可识别的原因引起的。
