Anaphylaxis

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Relevant Article Depot:

Perioperative anaphylaxis

Anaphylaxis Guidelines

Perioperative Anaphylaxis

Guidelines for Antibiotic Use

Emergency treatment of peri-operative anaphylaxis: Resuscitation Council UK algorithm for anaesthetists

Soy-allergic and Egg-allergic Patients Can Safely Receive Anesthesia

Propofol in children with allergies to egg, peanut, soybean or other legumes

No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut†

Anaesthetic hypersensitivity reactions in France between 2011 and 2012: the 10th GERAP epidemiologic survey

Perioperative anaphylaxis in children (Wake-Up Safe)

Sugammadex-induced anaphylactic reaction: A systematic review

Question of the Week #51

Practical guidelines for the response to perioperative anaphylaxis

Epidemiology of perioperative anaphylaxis in the United States: new insights but more to learn and do

Allergies and Anaphylaxis - Open Anesthesia

Anesthetic Care of Children with Food Allergies -Open Anesthesia Podcast

Increasing Cefazolin Use for Perioperative Antibiotic Prophylaxis in Penicillin-Allergic Children

Perioperative Anaphylaxis Management Guidelines

Sugammadex and rocuronium-induced anaphylaxis

Epidemiology of suspected life-threatening perioperative anaphylaxis: a cross-sectional multicentre study in China

Identification and Management of Perioperative Anaphylaxis

Immediate Hypersensitivity to Chlorhexidine: Experience from an Allergy Center in China

Cephalosporins can be prescribed safely for penicillin-allergic patients

Retrospective observational study of the incidence of peri-operative allergic hypersensitivity reactions to cefazolin

Pholcodine exposure increases the risk of perioperative anaphylaxis to neuromuscular blocking agents: the ALPHO case-control study

Sugammadex in the management of rocuronium-induced anaphylaxis

Role of sugammadex in the treatment of anaphylaxis due to rocuronium in children: Extrapolation from adult and animal reports

The cyclodextrin sugammadex and anaphylaxis to rocuronium: is rocuronium still potentially allergenic in the inclusion complex form?

Anaphylaxis during anesthesia in France: an 8-year national survey

Allergy during anaesthesia

Perioperative Anaphylaxis: Evaluation and Management

Refractory Anaphylaxis: A New Entity for Severe Anaphylaxis

Anaphylaxis induced by sugammadex and sugammadex-rocuronium complex -a case report-

Examining cefazolin utilization and perioperative anaphylaxis in patients with and without a penicillin allergy label: A cross-sectional study

Optimising peri-operative anaphylaxis management: end-tidal carbon dioxide monitoring and adrenaline titration

Pholcodine and allergy to neuromuscular blocking agents. Comment on Br J Anaesth 2024; 132: 457–60

The Pholcodine Story

Emergency treatment of peri-operative anaphylaxis: Resuscitation Council UK algorithm for anaesthetists

Management of Refractory Anaphylaxis: An Overview of Current Guidelines

Incidence of and risk factors for paediatric perioperative anaphylaxis in the USA

Perioperative anaphylaxis: an update on pathophysiology, diagnosis, and management

Sugammadex Anaphylaxis: Mechanisms, Diagnosis, and Incidence

Penicillin allergy risk stratification tool for use by non-allergists in the peri-operative setting: an agreement study and qualitative process evaluation

Jutel M, Agache I, Zemelka‐Wiacek M, Akdis M, Chivato T, Del Giacco S, Gajdanowicz P, Gracia IE, Klimek L, Lauerma A: Nomenclature of allergic diseases and hypersensitivity reactions: Adapted to modern needs: An EAACI position paper. Allergy 2023, 78(11):2851–2874.

Volcheck GW, Melchiors BB, Farooque S, Gonzalez-Estrada A, Mertes PM, Savic L, Tacquard C, Garvey LH: Perioperative hypersensitivity evaluation and management: a practical approach. The Journal of Allergy and Clinical Immunology: In Practice 2023, 11(2):382–392.

Learning from experience in perioperative allergy: how the patient voice should shape clinical care

Tacquard C, Iba T, Levy JH. Perioperative anaphylaxis. Anesthesiology. 2023 Jan; 138(1): 100-110. PMID: 36413685

Food, fads, allergies and anaphylaxis with propofol

Gadde J, Spence M, Wheeler B, Adkinson NF, Jr.: Clinical experience with penicillin skin testing in a large inner-city STD clinic. Jama 1993, 270(20):2456–2463.

Trubiano JA, Adkinson NF, Phillips EJ: Penicillin Allergy Is Not Necessarily Forever. Jama 2017, 318(1):82–83.

Campagna JD, Bond MC, Schabelman E, Hayes BD: The use of cephalosporins in penicillin-allergic patients: a literature review. J Emerg Med 2012, 42(5):612–620.

Prevention and Treatment of Peanut Allergy

News(from PAAD Mirror):

New Anaphylm sublingual epinephrine data address FDA’s concerns

Anaphylm (dibutepinephrine) is an investigational, needle-free sublingual film developed by Aquestive Therapeutics designed to treat severe allergic reactions and anaphylaxis. Roughly the size of a postage stamp, it dissolves under the tongue within seconds without water or swallowingKey Features

Format: Orally administered sublingual film.

Packaging: Slim foil pouch smaller than a credit card, pocket-portable.

Mechanism: Delivers a rapid surge of epinephrine through oral mucous membranes

Key Data Addressing FDA Concerns:The initial FDA rejection centered strictly on user errors during administration—such as tearing the film, chewing it, or placing it on top of the tongue—rather than safety or manufacturing flaws. The new data from Aquestive Therapeutics demonstrate that revised packaging and instructions have resolved these human factors issues:

Pouch-Opening Speed: Median time to open the foil pouch plummeted from 17 seconds to just 3 seconds.

Placement Accuracy: Incorrect film placement under the tongue was slashed by over 80%.

Zero Chewing Events: Updated instructions eliminated instances of participants chewing or early-removing the film.

Robust Absorption: Self-administered film delivered PK exposure comparable to clinician-administered dosing, achieving a fast median time to peak concentration (Tmax) of 12 minutes.