Paradoxical reaction to epinephrine induced by beta-blockers in an anaphylactic shock induced by penicillin

Eur J Emerg Med. 2006 Dec;13(6):358-60. doi: 10.1097/01.mej.0000217993.09364.35.

Abstract

Increased risk of severe and resistant anaphylactic shock is a rare and not widely known adverse effect of beta-blocker treatment. It is illustrated in a case of refractory anaphylactic shock occurring in a 47-year-old woman who received beta-blockers. Actually, beta-blockers increase the release of anaphylactic mediators, decrease the cardiovascular compensatory changes to the anaphylactic shock and promote paradoxical reflex vagotonic effects when using epinephrine.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Agonists / adverse effects*
  • Adrenergic beta-Agonists / therapeutic use
  • Adrenergic beta-Antagonists / adverse effects*
  • Amoxicillin / adverse effects*
  • Anaphylaxis* / chemically induced
  • Anaphylaxis* / drug therapy
  • Anti-Infective Agents / adverse effects*
  • Drug Administration Schedule
  • Drug Antagonism
  • Drug Synergism
  • Emergency Medical Services / methods
  • Emergency Treatment / adverse effects
  • Emergency Treatment / methods
  • Epinephrine / adverse effects*
  • Epinephrine / therapeutic use
  • Female
  • Humans
  • Hypertension / drug therapy
  • Medical History Taking
  • Medication Errors / adverse effects
  • Middle Aged
  • Practice Guidelines as Topic
  • Risk Factors
  • Self Administration / adverse effects
  • Vasoconstrictor Agents / adverse effects*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Adrenergic beta-Agonists
  • Adrenergic beta-Antagonists
  • Anti-Infective Agents
  • Vasoconstrictor Agents
  • Amoxicillin
  • Epinephrine