Delayed anaphylactic reaction to intravenous infusion of ondansetron report of 3 cases

Abstract

Ondansetron hydrochlorideis is a selective 5 hydroxy-tryptamine 3 (5-HT3) receptor antagonist widely used as an effective antiemetic especially for the prevention of chemotherapy-induced nausea and vomiting caused by highly emetogenic drugs such as Cisplatin.) When its used in combination with corticosteroids these agents result in complete protection from acute-onset emesis is between 70% and 80% of patients so It may be considered as gold standard for this purpose. All 5-HT3 receptor antagonists have been associated with asymptomatic electrocardiogram changes but anaphylactic shock or hypersensitivity to ondansetron was rarely reported. In this paper, we report 3 cases of delayed anaphylactic reaction to the drug cited above.

Delayed Anaphylaxis to Intravenous Colistin in a Critically Ill Cancer Patient: A Case Report

“…Cases of delayed anaphylaxis have been described with intravenous ondansetron, some of which were reported after receiving multiple doses with no adverse effects. [7][8][9] In a 1-year old pediatric girl with stage-IV neuroblastoma, anaphylaxis was reported with the 56th dose of ondansetron though the patient received earlier doses with no adverse reactions. 8 Montañez et al3 described cofactors that may increase the risk of anaphylaxis in patients, like the concomitant use of medication (Non-steroidal anti-inflammatory drugs, proton pump inhibitors, or angiotensin-converting enzyme), the presence of other medical conditions (asthma, cardiovascular diseases, or mastocytosis), emotional stress, and the use of alcohol.…”

“…In those cases, the onset of the allergic reactions began 12 hours to a few days after treatment. [3][4][5][6][7][8][9][10][11][12] In this report, we describe a patient who developed anaphylaxis to intravenous colistin after about a month of daily administration, during which he had no signs or symptoms suggestive of any form of allergies to the medication. In addition, we describe the outcomes following the re-administration of colistin after the initial episode of anaphylaxis.…”