Investigation on the application of epinephrine in the treatment of anaphylaxis
10.3760/cma.j.cn114015-20230302-00139
- VernacularTitle:严重过敏反应救治中肾上腺素应用的调查
- Author:
Manman ZHANG
1
;
Wei SHEN
1
Author Information
1. 宿迁市第一人民医院药学部，宿迁 223800
- Publication Type:Journal Article
- Keywords:
Anaphylaxis;
Epinephrine;
Drug-related side effects and adverse reactions;
Emergency treatment
- From:
Adverse Drug Reactions Journal
2023;25(9):527-532
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the use of epinephrine in the treatment of anaphylaxis in the hospital.Methods:The adverse drug reaction (ADR) reports of anaphylaxis in National Center for ADR Monitoring of China reported by Suqian First People Hospital from August 12, 2016 to November 30, 2022 were retrospectively analyzed. Patients with anaphylaxis were divided into shock group and non-shock group according to whether they had shock. The basic information, organs and systems involved, and severity of anaphylaxis, epinephrine use, and outcomes in patients of the 2 groups were compared. The application of epinephrine in patients with anaphylaxis of different manifestations, and the rationality of the dose and route of epinephrine were analyzed and evaluated descriptively.Results:A total of 132 patients with anaphylaxis were entered in this study, including 62 males (47.0%) and 70 females (53.0%), with a median age of 53 years. There were 20 patients (15.2%) in the shock group and 112 patients in the non-shock group (84.8%). In comparison of the involving organs and systems in the anaphylaxis between the 2 groups, the cardiovascular system [100% (20/20) vs. 17.9% (20/112)], nervous system [60.0% (12/20) vs. 28.6% (32/112)], digestive system [40.0% (8/20) vs. 15.2% (17/112)], and urinary system [15.0% (3/20) vs. 1.8% (2/112)] were affected more often in patients of the shock group, while skin and mucosa were affected more often in patients of the non-shock group [88.4% (99/112) vs. 60.0% (12/20)]. The differences were all statistically significant (all P<0.05). Only 21 (15.9%) of 132 patients with anaphylaxis used epinephrine in the treatment. The proportion of patients receiving epinephrine in the shock group was significantly higher than that in the non-shock group [50.0% (10/20) vs. 9.8% (11/112), P<0.001]. Of the 21 patients who used epinephrine, 10 (47.6%) had excessive dose, and 11 (52.4%) received through subcutaneous injection, which was not recommended in the guidelines. Conclusions:In the emergency treatment of anaphylaxis in patients in the Suqian First People Hospital, the proportion of epinephrine use is low, and there are also situations that the dosage and administration route are unreasonable. The awareness on the importance of rational use of epinephrine should be improved in medical staffs, and relevant training should be strengthened.
