Presentation
Cutaneous wheals and urticaria
Local phenomenon
Progression to anaphylaxis : rare
Mechanism
De granulation of mast cells : direct action
Drugs implicated
Vancomycin
Ciprofloxacin
Amphotericin B
Rifampicin
Teicoplanin
Cremophor : excipient in paclitaxel & cyclosporine
Management
For vancomycin
Slowing infusion rate or stopping
Prophylactic use of antihistamines
Repeated administration : tolerance can develop.
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