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首页> 外文期刊>Current opinion in anaesthesiology >Anesthesia in the patient with multiple drug allergies: are all allergies the same?
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Anesthesia in the patient with multiple drug allergies: are all allergies the same?

机译：具有多种药物过敏的患者中的麻醉：所有过敏都一样吗？

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PURPOSE OF REVIEW: During the preoperative evaluation, patients frequently indicate 'multiple drug allergies', most of which have not been validated. Potential allergic cross-reactivity between drugs and foods is frequently considered as a risk factor for perioperative hypersensitivity. The aim of this review is to facilitate the recognition of risk factors for perioperative anaphylaxis and help the management of patients with 'multiple drug allergies' during the perioperative period. RECENT FINDINGS: Neuromuscular blocking agents (NMBAs) and antibiotics are the most common drugs triggering perioperative anaphylaxis. Quaternary ammonium ions have been suggested to be the allergenic determinant of NMBAs. Even though the 'pholcodine hypothesis' has been suggested to explain the occurrence of NMBA-induced allergy, this concept remains unclear. Although many practitioners believe that certain food allergies present an issue with the use of propofol, there is no role to contraindicate propofol in egg-allergic, soy-allergic or peanut-allergic patients. IgE-mediated hypersensitivity has been reported with seafood and iodinated drugs, IgE-mediated hypersensitivity has been reported with seafood and iodinated drugs, but there is no cross-reactivity between them. The allergenic determinants have been characterized for fish, shellfish and povidone iodine and remain unknown for contrast agents. SUMMARY: There are many false assumptions regarding drug allergies. The main goal of this article is to review the potential cross-reactivity among specific families of drugs and foods in order to facilitate the anesthetic management of patients with 'multiple drug allergies'.
机译：审查目的：在术前评估中，患者经常表现出“多种药物过敏”，其中大多数尚未得到验证。药物和食物之间潜在的过敏性交叉反应经常被认为是围手术期超敏反应的危险因素。这篇综述的目的是促进围手术期过敏反应的危险因素的识别，并在围手术期帮助管理“多种药物过敏”的患者。最近的发现：神经肌肉阻滞剂（NMBA）和抗生素是触发围手术期过敏的最常见药物。季铵离子已被认为是NMBAs的致敏决定因素。尽管已经提出了“膦膦假说”来解释NMBA引起的过敏的发生，但这一概念仍不清楚。尽管许多从业人员认为使用丙泊酚会引起某些食物过敏问题，但在鸡蛋过敏，大豆过敏或花生过敏的患者中没有禁忌使用丙泊酚的作用。已经报道了海鲜和碘化药物对IgE介导的超敏反应，已经报道了海鲜和碘化药物对IgE介导的超敏反应，但是它们之间没有交叉反应。鱼类，贝类和聚维酮碘的过敏原决定因素已被表征，而造影剂仍未知。摘要：关于药物过敏有许多错误的假设。本文的主要目的是审查特定药物和食品家族之间潜在的交叉反应性，以便于对“多种药物过敏”患者进行麻醉管理。

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