Analysis of Anaphylactic Shock Caused by 17 Types of Traditional Chinese Medicine Injections Used to Treat Cardiovascular and Cerebrovascular Diseases

Yang, Guo; Wang, Dewang; Meng, Ling; Wang, Yongqing

doi:10.1155/2015/420607

Cited by 17 publications

(15 citation statements)

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“…Of the 135 patients who suffered anaphylaxis induced by TCM injections, patients’ age ranged from 4 to 90 years: children under 18 years (5%), adults between 18 and 59 years (58.6%), and adults over 60 years (36.4%). This is consistent with a previous study reporting that patient of any age can suffer anaphylaxis induced by TCM injections [ 22 ]. Therefore, caution should be exercised before considering the use of TCM and all patients regardless of age should be closely monitored during TCM administration.…”

Section: Discussionsupporting

confidence: 93%

“…TCM injection is extracted from Chinese herbs, which may contain one or several active ingredients. The high frequency of anaphylactic cases related to TCM injections may be explained as follows: (1) the components of a TCM injection are relatively complex and most formulations have not been thoroughly analyzed and identified; (2) a TCM injection also contains various additives, such as pigment, tannin, starch and protein, and these additives may trigger the body’s immune system and cause anaphylaxis [ 22 ]; (3) quality control of TCM injections is relatively difficult due to the formulation complexity, and impurities may cause anaphylaxis as well; and (4) drug interactions between TCM injections and other medications should also be considered. Of the 135 patients who suffered anaphylaxis induced by TCM injections, patients’ age ranged from 4 to 90 years: children under 18 years (5%), adults between 18 and 59 years (58.6%), and adults over 60 years (36.4%).…”

Section: Discussionmentioning

confidence: 99%

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Drug-induced anaphylaxis in China: a 10 year retrospective analysis of the Beijing Pharmacovigilance Database

Zhao

Sun

et al. 2017

Int J Clin Pharm

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Background Few studies on the causes of drug-induced anaphylaxis (DIA) in the hospital setting are available. Objective We aimed to use the Beijing Pharmacovigilance Database (BPD) to identify the causes of DIA in Beijing, China. Setting Anaphylactic case reports from the BPD provided by the Beijing Center for Adverse Drug Reaction Monitoring. Method DIA cases collected by the BPD from January 2004 to December 2014 were adjudicated. Cases were analyzed for demographics, causative drugs and route of administration, and clinical signs and outcomes. Main outcome measure Drugs implicated in DIAs were identified and the signs and symptoms of the DIA cases were analyzed. Results A total of 1189 DIA cases were analyzed. The mean age was 47.6 years, and 732 (61.6%) were aged from 18 to 59 years. A total of 627 patients (52.7%) were females. There was a predominance of cardiovascular (83.8%) followed by respiratory (55.4%), central nervous (50.1%), mucocutaneous (47.4%), and gastrointestinal symptoms (31.3%). A total of 249 different drugs were involved. DIAs were mainly caused by antibiotics (39.3%), traditional Chinese medicines (TCM) (11.9%), radiocontrast agents (11.9%), and antineoplastic agents (10.3%). Cephalosporins accounted for majority (34.5%) of antibiotic-induced anaphylaxis, followed by fluoroquinolones (29.6%), beta-lactam/beta-lactamase inhibitors (15.4%) and penicillins (7.9%). Blood products and biological agents (3.1%), and plasma substitutes (2.1%) were also important contributors to DIAs. Conclusion A variety of drug classes were implicated in DIAs. Patients should be closely monitored for signs and symptoms of anaphylaxis when medications are administered especially with antibiotics, TCM, radiocontrast and antineoplastic agents.Electronic supplementary materialThe online version of this article (doi:10.1007/s11096-017-0535-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Drug-induced anaphylaxis in China: a 10 year retrospective analysis of the Beijing Pharmacovigilance Database

Zhao

Sun

et al. 2017

Int J Clin Pharm

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“…Notably, our data suggests that, in addition to these known triggers, traditional Chinese medicine injections are one of the top triggers of DIA in Beijing, which is consistent with a recent study by Jiang et al [11]. Further studies regarding the safety of traditional Chinese medicine injections are thus warranted [29]. A high proportion of patients developed cardiovascular symptoms (83.8%), and the mortality rate of 3.3% was comparable to those of previous studies [5,30].…”

Section: Discussionsupporting

confidence: 90%

Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the Beijing Pharmacovigilance Database

Wang

Ma²,

Xing

et al. 2017

Int Arch Allergy Immunol

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Background: Few studies assessing the use of epinephrine in drug-induced anaphylaxis (DIA) in the hospital setting are available. We utilized the Beijing Pharmacovigilance Database (BPD) to evaluate the appropriateness of epinephrine for DIA management. Methods: DIA cases collected in the BPD from January 2004 to December 2014 were adjudicated and analyzed for demographics, causative drugs, clinical signs, outcomes, initial treatment, route, dosing, and cardiovascular adverse events (CAE) of epinephrine. Results: DIA was primarily caused by antibiotics (38.4%), radiocontrast agents (11.9%), traditional Chinese medicine injections (10.9%), and chemotherapeutic drugs (10.3%). Only 708 (59.5%) patients received epinephrine treatment. Patients who received epinephrine were more likely to experience wheezing (p < 0.001) and respiratory arrest (p < 0.001). Among 518 patients with a complete record of the epinephrine administration route, the percentage of patients receiving it by intramuscular (IM) injection, subcutaneous (SC) injection, intravenous (IV) bolus injection, or IV continuous infusion was 16.9, 31.5, 43.5, and 8.1%, respectively. Among the 427 patients with a record of both the administration route and the dosing, an overdose was more likely with IV bolus (94.1%) in contrast to IM injection (56.6%; p < 0.001) or SC injection (43.7%; p < 0.001). Among the patients analyzed for CAE (n = 349), 17 patients accounted for 19 CAE, and 13 (76.5%) of these patients were overdosed with epinephrine. Conclusion: Underuse, inappropriate IV bolus use, and overdosing were the 3 major problems with epinephrine use in DIA in China. Educational training for health care professionals on the appropriate use of epinephrine in managing anaphylactic reactions is suggested.

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“…PubMed 데이터베이스를 활용하여("china" and "anaphylaxis") or ("chinese herbal injection" or "herbal injection" or "Chinese Medicine Injection"or "Traditional Chinese medicine injection") and ("Risk" or "profile" or "post-marketing" or "Adverse" or "Anaphylaxis" or "Review" or "Quality" or "Safety") 검색어를 통해 중국에서의 아나필락시스 관련 문 32,36,37,39) . 16,17,28,30) .…”

Section: 방법»»»mentioning

confidence: 99%

Adverse Drug Reaction of Chinese Herbal Injection: Focusing on the Anaphylaxis Reaction

Jeung

Jeon

2020

J Korean Med Rehabil

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Objectives Studies on Chinese herbal injections are increasing. But, its safety are still not well reported. We have reviewed the literature related to the safety of Chinese herbal injection, especially those related to anaphylaxis. Methods The PubMed database was used to select the literatures related to anaphylaxis in China and to study the quality control and safety of Chinese herbal injection. Results Chinese herbal injection is a major traditional medical treatment in China, but it is the cause of adverse drug reactions including anaphylaxis. In order to solve this problem, various proposals have been made to identify the pharmacological and chemical causes of major side effects and to use them safely clinically. In addition, various researches have been conducted from preclinical to postmarketing surveillance to secure the safety of Chinese herbal injection. Based on this, it was found that various efforts are needed to secure the safety of bee sting needles. Conclusion In order to secure the safety of chinese herbal injections, it is necessary to identify the main mechanism of action and the pharmacological components contributing to it, and to develop a standardized formulation based on this. In addition, institutional pharmacovigilance is required.

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Analysis of Anaphylactic Shock Caused by 17 Types of Traditional Chinese Medicine Injections Used to Treat Cardiovascular and Cerebrovascular Diseases

Cited by 17 publications

References 2 publications

Drug-induced anaphylaxis in China: a 10 year retrospective analysis of the Beijing Pharmacovigilance Database

Drug-induced anaphylaxis in China: a 10 year retrospective analysis of the Beijing Pharmacovigilance Database

Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the Beijing Pharmacovigilance Database

Adverse Drug Reaction of Chinese Herbal Injection: Focusing on the Anaphylaxis Reaction

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