The incidence of anaphylaxis or anaphylactic shock is most
common after treatment with certain local anesthetics and
other drugs which may be used during a procedure.
Anaphylaxis, or anaphylactic shock, is a systemic
hypersensitivity reaction that can occur when an individual
is exposed to a substance to which he/she has become highly
allergic. It is a form of circulatory collapse, but is not
considered a true shock because it is readily managed by the
combination of transient circulatory and respiratory support
It may occur after food ingestion, particular insect and
snake bites, and, most often, after treatment with certain
drugs, especially antibiotics (Penicillins, cephalosporins,
streptomycin), non-steroidal anti-inflammatory agents,
cardiac depressants, antiarrhythmics (Procainamide and
quinidine), local anesthetics, fluorescein, and other drugs.
Reactions are more likely to occur after parenteral rather
than oral administration. Almost always the patient gives a
history of previous exposure to the drug.
The anaphylactic mechanism is a two phase reaction:
1st Phase: The antigen is introduced causing the formation
of specific antibodies. The individual is now sensitized
to the antigen.
2nd Phase: With subsequent exposure to the antigen, there
is the hypersensitive response with the previously
Approved By Governing Board