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Potential Anaphylaxis to Systemic Phenylephrine: A Case Report.
1Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Hospital Pharmacy
|January 15, 2024
Summary
A patient with asthma experienced a severe allergic reaction to phenylephrine, a medication used for hypotension. This highlights the risk of sulfite hypersensitivity in patients with a history of allergic conditions.
Area of Science:
- Anesthesiology
- Allergy and Immunology
- Pharmacology
Background:
- A 66-year-old female with a history of asthma, breast cancer, anxiety, and chronic back pain underwent spinal surgery.
- The patient presented for spinal hardware removal and fusion procedures at L5-S1 and L4-L5, respectively.
Observation:
- Postoperatively, the patient developed acute blood loss anemia and hypotension, managed with a phenylephrine infusion.
- This led to a suspected anaphylactic reaction, necessitating transfer to the intensive care unit for management.
Findings:
- The patient's hypersensitivity reaction was likely due to sodium metabisulfite, a sulfite preservative in phenylephrine.
- Phenylephrine's structural similarity to endogenous catecholamines complicated the initial diagnosis of the allergic reaction.
Implications:
- Patients with a history of allergic reactions require close monitoring for hypersensitivity to medication preservatives and excipients.
- This case underscores the importance of considering sulfite sensitivity in patients with asthma presenting with unexpected allergic responses.
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