Clinical value of morphine, pholcodine and poppy seed IgE assays in drug-abusers and allergic people

Armentia, Alicia; Ruiz-Muñoz, Pedro; Martínez, Javier Jesús González; Postigo, Idoia; Herrero, M.; Martín-Gil, F.J.; González-Sagrado, Manuel; Martín, Blanca Garrido; Castrodeza, J.

doi:10.1016/j.aller.2011.05.011

Cited by 16 publications

(11 citation statements)

References 25 publications

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“…Finally, unlike Armentia et al. , we do not endorse the use of sIgE antibodies to poppy seed as a marker to document genuine opiate allergy. First, the currently available poppy seed assay uses an aqueous extract that is prepared from native allergens and contains highly cross‐reactive components and epitopes, such as CCD and ubiquitous pan allergens such as profilins and ns‐LTP that might severely hamper correct diagnosis of opiate allergy .…”

Section: Cns Depressants (Cannabis Opioids and Kava)contrasting

confidence: 90%

Allergy to illicit drugs and narcotics

Swerts

Gasse

Leysen

et al. 2014

Clin Experimental Allergy

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Despite their frequent use, allergy to illicit drugs and narcotics is rarely reported in literature. We present a review of the different classes of drugs of abuse that might be involved in allergies: central nervous system (CNS) depressants (such as cannabis, opioids and kava), CNS stimulants (cocaine, amphetamines, khat and ephedra) and hallucinogens such as ketamine and nutmeg. Diagnosis of drug and narcotic allergy generally relies upon careful history taking, complemented with skin testing eventually along with quantification of sIgE. However, for various reasons, correct diagnosis of most of these drug allergies is not straightforward. For example, the native plant material applied for skin testing and sIgE antibody tests might harbour irrelevant IgE-binding structures that hamper correct diagnosis. Diagnosis might also be hampered due to uncertainties associated with the non-specific histamine releasing characteristics of some compounds and absence of validated sIgE tests. Whether the introduction of standardized allergen components and more functional tests, that is, basophil activation and degranulation assays, might be helpful to an improved diagnosis needs to be established. It is anticipated that due to the rare character of these allergies further validation is although necessary.

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Section: Cns Depressants (Cannabis Opioids and Kava)contrasting

confidence: 90%

Allergy to illicit drugs and narcotics

Swerts

Gasse

Leysen

et al. 2014

Clin Experimental Allergy

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“…Los niveles más altos de IgE específi ca se relacionan con cuadros clínicos más severos. 51 La prueba de IgE específi ca a las semillas de amapola tiene una sensibilidad de 82.6 % y una especifi cidad de 100 %. 4 Otro método diagnóstico es la IgE sérica específi ca para el fármaco.…”

Section: Diagnósticounclassified

“…39 Se puede utilizar la prueba ImmunoCAP para el amonio cuaternario de la morfi na e ImmunoCAP para alérgenos de la folcodina. 51 Las pruebas cutáneas por escarifi cación detectan efi cientemente la sensibilización a los opiáceos. Se puede realizar una prueba cutánea con un extracto de semillas de opio (Papaver somniferum), que tiene una sensibilidad de 64.2 % y una especifi cidad de 98.4 %, mayor que las pruebas de morfi na, la codeína y rocuronio para ver la sensibilidad a los opiáceos.…”

Section: Diagnósticounclassified

“…El área de la pápula se mide después de 15 minutos y una roncha ≥ 19.62 mm 2 , lo que corresponde a un diámetro de 5 mm, es considerada claramente positiva. 51 La prueba cutánea por escarifi cación específi ca para la morfi na tiene una sensibilidad de 43.5 % y una especifi cidad de 98.1 %; se utiliza una concentración de 10 mg/mL. 52,53 La prueba cutánea por escarifi cación específi ca para la folcodina tiene una sensibilidad de 30.4 % y una especifi cidad de 100 %.…”

Section: Diagnósticounclassified

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Reacciones adversas inmunitarias y no inmunitarias a fármacos de uso perioperatorio

González-Díaz

Arias-Cruz

Monge-Ortega

2019

RAM

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Las reacciones a medicamentos pueden ocurrir por mecanismos mediados o no por imunoglobulina E. La alergia a fármacos es un tipo de interacción adversa y comprende una gama de reacciones de hipersensibilidad mediadas por distintos mecanismos inmunológicos con diversas manifestaciones clínicas. Se estima una tasa anual de 3.2 casos fatales de anafilaxia asociados con los fármacos por cada 100 000 habitantes, que parece ser aproximadamente 10 veces mayor en los pacientes hospitalizados. La incidencia de reacciones anafilácticas perioperatorias se estima en uno de cada 10 000-20 000 procedimientos anestésicos. El diagnóstico se basa en una cuidadosa historia clínica y en el examen físico. En algunos casos pueden requerirse pruebas cutáneas, pruebas de retos progresivos y procedimientos de inducción de tolerancia al medicamento. En los pacientes hospitalizados y en el intervalo perioperatorio frecuentemente se emplean relajantes musculares, neurolépticos y morfinomiméticos, por lo que pueden presentarse respuestas adversas a estos fármacos. En esta revisión se hace énfasis en las reacciones alérgicas a los medicamentos y se abordan estrategias para su diagnóstico y manejo.

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“…Modern research has shown that PPCE acts by modulating pain signaling pathways in the central nervous system. Varieties of pharmacological effects of PPCE have been found according to the previous studies, such as sedation, anti-tussive, and anti-diarrheal [2][3][4]. Among the chemical components of PPCE, isoquinoline alkaloids such as morphine (MPE) and codeine (CON) have been demonstrated to be the main and dominant active compounds [5,6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the quality consistency of powdered poppy capsule extractive by an averagely linear‐quantified fingerprint method in combination with antioxidant activities and two compounds analyses

Zhang

Sun

Hou

et al. 2017

J of Separation Science

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A novel averagely linear-quantified fingerprint method was proposed and successfully applied to monitor the quality consistency of alkaloids in powdered poppy capsule extractive. Averagely linear-quantified fingerprint method provided accurate qualitative and quantitative similarities for chromatographic fingerprints of Chinese herbal medicines. The stability and operability of the averagely linear-quantified fingerprint method were verified by the parameter r. The average linear qualitative similarity SL (improved based on conventional qualitative "Similarity") was used as a qualitative criterion in the averagely linear-quantified fingerprint method, and the average linear quantitative similarity PL was introduced as a quantitative one. PL was able to identify the difference in the content of all the chemical components. In addition, PL was found to be highly correlated to the contents of two alkaloid compounds (morphine and codeine). A simple flow injection analysis was developed for the determination of antioxidant capacity in Chinese Herbal Medicines, which was based on the scavenging of 2,2-diphenyl-1-picrylhydrazyl radical by antioxidants. The fingerprint-efficacy relationship linking chromatographic fingerprints and antioxidant activities was investigated utilizing orthogonal projection to latent structures method, which provided important pharmacodynamic information for Chinese herbal medicines quality control. In summary, quantitative fingerprinting based on averagely linear-quantified fingerprint method can be applied for monitoring the quality consistency of Chinese herbal medicines, and the constructed orthogonal projection to latent structures model is particularly suitable for investigating the fingerprint-efficacy relationship.

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Clinical value of morphine, pholcodine and poppy seed IgE assays in drug-abusers and allergic people

Abstract: Opiates may be significant allergens. Drug-abusers and people sensitised to tobacco are at risk. Both the prick and specific IgE tests efficiently detected sensitisation to opiates. The highest levels were related to more-severe clinical profiles.

Cited by 16 publications

References 25 publications

Allergy to illicit drugs and narcotics

Allergy to illicit drugs and narcotics

Reacciones adversas inmunitarias y no inmunitarias a fármacos de uso perioperatorio

Evaluation of the quality consistency of powdered poppy capsule extractive by an averagely linear‐quantified fingerprint method in combination with antioxidant activities and two compounds analyses

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