Analysis of ceftriaxone-induced anaphylactic shock(分析ceftriaxone-induced过敏性休克)

Analysisofceftriaxone-inducedanaphylacticshock[PaperKeywords]ceftriaxone;anaphylacticshock;Ⅰ-typehypersensitivity[Abstract]Ceftriaxoneiscommonlyusedinclinicalthird-generationcephalosporinantibiotics,allergyisoneofitsadversereactions,anaphylacticshockisthemostseriousallergicreaction,allergicconstitutionoftenoccurimmediatelyafterapplication.DrugSomecrosswithpenicillinallergy,sothehistoryofpenicillinallergycaution,ceftriaxoneallergy.Thepatientshadnohistoryofallergytopenicillin,ceftriaxoneskintestnegative,andthecontinuousoccurrenceofdrugallergy-free3d,thefirstfourdaysofsevereanaphylacticshock,clinicallyrare.maybeimpurewithdrugsorlowmolecularweightimpuritiesanddegradationproductsformedwiththebody’sproteinsshouldchangedollars,sothatthebodytypeⅠallergyrelatedsensitizationoccurs.colleaguesinthissituationdeservesattention.Ceftriaxoneiswidelyusedclinically,few1medicationallergyallergycanbemild,suchasskinrashes,allergicdermatitis,urticaria,pruritus,erythemamultiforme,bronchospasm,etc.Theanti-allergytreatment,symptomscanbequicklydisappear.veryfewmaybesevereanaphylacticshock,oftenoccursinafewseconds-minutes,developmentanddeath.Ihadseenapatientintheclinicaltreatmentinacontinuousprocessinthefirstfourdaysofsevereanaphylacticshockwithstress-inducedgastrointestinalbleeding,activerescuecured.Arereportedasfollows:AmedicalrecordsPatients,female,44yearsold.Becauseofabdominalpain,chills,fever2dtreatment.2dbeforethepatientoutsidethehospitalcervicalpolypectomy,aftertheafternoonaccompaniedbylowerabdominalpain,chills,fever,T:37.8℃,athomefromantibiotics(specificallyunknown)2d,invalid,thentoourhospital.admissionexamination:T38.2℃,BP112/80mmHg,noabnormalheartandlung,abdomenflat,positiveabdominaltenderness,leftlowerquadranttendernessandreboundtendernesswerepositive,muscleguardingnegative,noascites.bloodwhitebloodcell15.4*109/L,neutrophils0.82;Bpelvicultrasound2showedasmallamountoffluid.diagnosis:cervicalpolypsurgeryandacutepelvicperitonitisadmittedtohospitalafterlineofanti-infectiontreatmentnoprevioushistoryofallergytopenicillinandcephalosporins,ceftriaxoneNapiertest(-)togive5%glucosesaline250ml,ceftriaxone3.0g(ZhejiangAsia-PacificLtd.,ZhunziH200045189)intravenously,day1times,continuousapplicationof3d,withoutanyadversedrugreactions,patientsymptoms;thefirst4dayscontinuedwithceftriaxone(ZhejiangAsia-PacificLtd.,theproductionlotnumber090204)infusion,about2mlofliquiddrops,thepatientcomplaintsmouthpain,dizziness,chesttightness,skinitching,followedbynausea,sweating,difficultybreathing,skinflushingwithtrunklimbs,urticaria,lipswelling,bloodpressure76/30mmHg,immediatelyreplacetheliquidwith5%glucose500mlrapidintravenousinfusionofsaline,oxygentherapy,subcutaneousinjectionofepinephrine0.5mg,intravenousinjectionofdexamethasone15mg,intramuscularinjectionofpromethazine25mg.observed10min,cannotrelievesymptoms,lips,fingersandcyanosis,coldlimbs,notpalpableradialarterypulse,no3responsetoorbitalpressure,coma,bloodpressure20/0mmHg,again,subcutaneousinjectionofepinephrine1mg,intramuscularinjectionofpromethazine25mg,10%slowintravenousinjectionofcalciumgluconate20ml,intravenousnaloxone0.8mg,theotherconstructionoftherapidexpansionofvenousaccess,5%glucose500mlsalineplusdopamine100mg,25drops/mininfusion.3h,enterRinger,5%sugar,salt,generationofplasma,5%sodiumbicarbonatesolutionabout2750ml,patientsgraduallyclear.extremities...

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