Author/Authors :
Yousefi, Hesam Department of Pharmaceutical Management - Sajad Hospital, Kermanshah , Moayedi, Siamak Department of Emergency Medicine - University of Maryland School of Medicine - Baltimore - USA , Harorani, Mehdi Department of Nursing - School of Nursing and Midwifery - Arak University of Medical Sciences , Sahebi, Ali Clinical Research Development Unit - Shahid Mostafa Khomeini Hospital - Ilam University of Medical Sciences, Ilam , Golitaleb, Mohamad Department of Nursing - School of Nursing and Midwifery - Arak University of Medical Sciences
Abstract :
Proton pump inhibitors (PPIs) block gastric acid secretion by inhibiting the hydrogen/potassium adenosine triphosphatase enzyme system. These drugs are used to treat gastric ulcers, esophagitis, duodenal ulcers,
Zollinger-Ellison syndrome, Barrett’s esophagus, and gastroesophageal
reflux disease (1, 2). Although PPIs have acceptable
safety, their administration can result in allergic
and anaphylactic reactions. Although these reactions, either
immediate or delayed, are unusual, they can be life
threatening. A number of publications have reported anaphylactic
reactions after administration of PPIs. The actual
rate of adverse reactions to these drugs is unknown
(3-5). We describe a case of anaphylactic reaction to an
intravenous administration of pantoprazole in a patient
treated for a presumed peptic ulcer. A 45-year-old male was
presented to our Emergency Department complaining of
four days of increasing epigastric pain. The pain was limited
to the epigastric area without radiation. The pain was
improved immediately after eating meals, however, it intensified
30 minutes afterwards. The patient had defecated
twice daily without melena and hematochezia. He did not
have any vomiting. He was mildly tender to the palpation
of the epigastric region. The patient and her family had
no history of allergic diseases and drug hypersensitivity.
In addition, the patient declared that he had consumed
nothing before taking Pantazole. The patient’s vital signs
at the time of admission were as follows: heart rate (HR) =
88 bpm, respiratory rate (RR) = 17 bpm, oxygen saturation
(O2Sat) = 95%, and blood pressure (BP) = 140/95 mmHg. The
patient was diagnosed with a presumed peptic ulcer. He
was treated with a 40 mg intravenous does of pantoprazole.
After three minutes of injection initiation, the patient
developed hives, itching, erythema of the upper extremities angioedema, hypotension, cyanosis, and dyspnea. The
vital signs were as follows: HR = 116 bpm, RR = 8 bpm, O2Sat = 75% and BP = 80/60 mmHg.
Keywords :
Allergic Reaction , Pantoprazole , Anaphylaxis , Proton Pump Inhibitors , Hypersensitivity
