Snider Christopher S, Hasara Shannon L, Wilson Kayla M, Glueck Jesse A, Barbera Andrew R
Department of Pharmacy, Lakeland Regional Health, Lakeland, USA.
Department of Emergency Medicine, Lakeland Regional Health, Lakeland, USA.
Cureus. 2023 Feb 17;15(2):e35119. doi: 10.7759/cureus.35119. eCollection 2023 Feb.
There has been an increase in allergy-related emergency department (ED) visits over the past several years. Underlying cardiovascular disease or respiratory disease and concurrent beta blocker or angiotensin-converting enzyme inhibitor use have been identified as potential risk factors for severe or refractory anaphylactic reactions. Conflicting evidence exists regarding the association between antihypertensive (AH) use and the incidence of refractory anaphylaxis.
The purpose of this study was to determine the incidence of refractory anaphylaxis in patients presenting to the ED while prescribed select AH medications outpatient.
This was a retrospective cohort study of all adult and pediatric patients presenting to the ED between February 16, 2021, and August 31, 2021, with a diagnosis of anaphylaxis. The primary objective was to compare the proportion of patients experiencing refractory anaphylaxis that were prescribed versus not prescribed AH medications in the outpatient setting.
A total of 101 patients were treated for anaphylaxis in the ED during the study timeframe with 13 patients in the AH group and 88 patients in the no AH group. There was no difference in the incidence of refractory anaphylaxis between groups (0% vs 9%; p=0.48). Significantly fewer patients in the AH group required any epinephrine doses compared to the no AH group (38% vs 88%; p<0.001).
Outpatient use of select AH medications was not associated with an increased incidence of refractory anaphylaxis in patients presenting to the ED.
在过去几年中，与过敏相关的急诊科就诊人数有所增加。潜在的心血管疾病或呼吸系统疾病以及同时使用β受体阻滞剂或血管紧张素转换酶抑制剂已被确定为严重或难治性过敏反应的潜在危险因素。关于使用抗高血压药（AH）与难治性过敏反应发生率之间的关联，存在相互矛盾的证据。
本研究的目的是确定在门诊开具特定AH药物的情况下，就诊于急诊科的患者中难治性过敏反应的发生率。
这是一项回顾性队列研究，研究对象为2021年2月16日至2021年8月31日期间就诊于急诊科且诊断为过敏反应的所有成人和儿童患者。主要目的是比较在门诊环境中开具与未开具AH药物的患者中发生难治性过敏反应的比例。
在研究期间，共有101例患者在急诊科接受了过敏反应治疗，其中AH组有13例患者，非AH组有88例患者。两组之间难治性过敏反应的发生率没有差异（0%对9%；p=0.48）。与非AH组相比，AH组中需要使用任何肾上腺素剂量的患者明显更少（38%对88%；p<0.001）。
门诊使用特定的AH药物与就诊于急诊科的患者中难治性过敏反应发生率的增加无关。
