Fatal anaphylactic reaction to intravenous infusion of Ondansetron: a report of two cases

Ouni, Bouraoui; Bensayed, Nessrine; Fathallah, Neila; Slim, Raoudha; Regaïeg, H.; Achour, B.; Benyoussef, Yosra; Khélif, Abderrahim; Salem, Chaker Ben

doi:10.15226/2476-2431/2/2/00119

Cited by 4 publications

(6 citation statements)

References 13 publications

(25 reference statements)

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“…Antibiotics are another group of drugs that have caused allergic reactions in patients who reported to the Department of Oral Medicine and Periodontology. This is another confirmation of the most commonly described medicinal allergies to antibiotics, i.e., penicillin preparations [16][17][18] . It is thought that 10% of people are allergic to penicillin 19 .…”

Section: Discussionsupporting

confidence: 70%

“…Znatan broj radova pokazuje na čestu pojavu alergija na lekove 16,17,19,24 . Zabeleženo je nekoliko stotina lekova koji mogu dovesti do neke reakcije preosetljivosti.…”

Section: Discussionunclassified

“…A significant number of works show a frequent allergy to medication 16,17,19,24 . There are several hundreds of drugs that can lead to a certain hypersensitivity reaction.…”

Section: Discussionmentioning

confidence: 99%

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Allergic manifestations in oral cavity

Minić¹,

Pejčić²,

Obradoviç³

et al. 2018

Acta stomatologica Naissi

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Uvod: Alergija je neuspešan odgovor organizma protiv stranih antigena. Ponovno uvođenje iste strane materije u organizam izaziva reakciju koja dovodi do uništavanja sopstvenog tkiva. Alergijske reakcije se mogu izraziti u različitim organima i u bilo kojoj starosnoj grupi. Materijal i metode: U ovom radu učestvovalo je 84 pacijenta. Dijagnoza je zasnovana na pozitivnoj anamnezi preordiniranja leka, ugriza insekata, ranijih alergijskih reakcija, kao i tipične kliničke slike. Pratile su se varijante alergijskih promena , kao i najčešći uzroci njihove pojave. U potrazi za najčešćim alergenima, lekovi u stomatološkoj praksi takođe su smatrani potencijalnim pokretačima alergijskih događaja. Rezultati: Najčešći oblik alergijske reakcije bio je Stomatitis allergica i Enanthema fixum, sa lokalizacijom na dorzalnoj površini jezika i sluzokožom obraza. Skoro polovina registrovanih pacijenata prijavila je promenu nakon uzimanja odgovarajućeg leka iz grupe sulfonamida i penicilina. Zaključak: Ako je uzrok alergija poznat, prevencija kontrole alergijske reakcije je na prvom mestu. Visoka prevalenca alergijskih bolesti, poboljšane dijagnostičke procedure i tretmani imali su veliki uticaj na pružanje medicinske zaštite pacijentima sa alergijom. Ponekad možda neće biti moguće potpuno izbeći alergijsku reakciju , ali ovi koraci mogu pomoći u sprečavanju budućih alergijskih reakcija. Lekari treba da usvoje jasne nazive alergijskih poremećaja i pridržavaju se nomenklature u njihovoj profesionalnoj i javnoj komunikaciji.

show abstract

Section: Discussionsupporting

confidence: 70%

“…Znatan broj radova pokazuje na čestu pojavu alergija na lekove 16,17,19,24 . Zabeleženo je nekoliko stotina lekova koji mogu dovesti do neke reakcije preosetljivosti.…”

Section: Discussionunclassified

See 1 more Smart Citation

Allergic manifestations in oral cavity

Minić¹,

Pejčić²,

Obradoviç³

et al. 2018

Acta stomatologica Naissi

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“…However, these reactions can be severe: two cases of fatal anaphylaxis attributed to ondansetron have been reported. 49 We observed a single case of propofol allergy. Propofol is an extremely uncommon cause of anaphylaxis.…”

Section: Miscellaneous Agentsmentioning

confidence: 78%

Anaesthesia, surgery, and life-threatening allergic reactions: epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6)

Harper

Cook

Garcez

et al. 2018

British Journal of Anaesthesia

390

413

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“…Ondansetron is widely recognized as possessing a low rate of adverse effects, and thus, many anesthetists are apt to employ it commonly for prophylaxis of postoperative nausea and vomiting. Nevertheless, a PubMed search reveals numerous hypersensitivity reactions [1][2][3][4]. Hence, ondansetron should be used with circumspection in the perioperative period.…”

Section: Introductionmentioning

confidence: 99%

Ondansetron-Induced Anaphylactic Shock: An In-Depth Analysis of a Rare Adverse Event

Suzuki¹,

Liu²,

Iwata³

et al. 2023

Cureus

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Ondansetron, a drug predominantly employed in most general anesthesia cases, is critical for mitigating postoperative nausea and vomiting prompted by anesthetics. Although infrequent side effects such as serotonin syndrome are recognized, the drug is generally acknowledged for its safety. Nonetheless, some reports showed cases of anaphylactic shock associated with ondansetron. In this context, we have meticulously analyzed an anaphylactic case triggered by ondansetron that we encountered. Our deep-dive investigation suggests that the reaction might not be a traditional type I allergic reaction, typically associated with the drug. Instead, we present the possibility that the response could be mediated through Mas-related G protein-coupled receptor X2 (MRGPRX2), a divergent pathway leading to comparatively milder symptoms of anaphylaxis. In addition to the crucial role of adrenaline in unstable hemodynamics, our case highlights the effective use of antihistamines in rapidly managing such reactions. This finding suggests a need to further examine the safety profiles of common drugs like ondansetron and the potential involvement of MRGPRX2 in drug-induced hypersensitivity reactions.

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Fatal anaphylactic reaction to intravenous infusion of Ondansetron: a report of two cases

Cited by 4 publications

References 13 publications

Allergic manifestations in oral cavity

Allergic manifestations in oral cavity

Anaesthesia, surgery, and life-threatening allergic reactions: epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6)

Ondansetron-Induced Anaphylactic Shock: An In-Depth Analysis of a Rare Adverse Event

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