Drug intelligence & clinical pharmacy
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Anaphylaxis is an acute, often life-threatening systemic reaction to mediators released by basophils and mast cells. Histamine, leukotrienes, prostaglandins, and other mediators are responsible for complex and varied reactions in man. Serious cardiovascular or pulmonary involvement can lead to death within minutes. ⋯ Even in ideal clinical settings, response to therapy may be slow and a long resuscitation necessary. Antihistamines, glucocorticoids, intravascular volume expansion, sympathomimetics, bronchodilators, and controlled ventilation all may be necessary. Taking careful allergy histories; using enteral routes for drug administration when possible; observing patients, who have received injections for at least 20 minutes; and rapidly treating patients with epinephrine are the main means of reducing the incidence and mortality of this disease.
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A wide variety of pharmacologic agents have been implicated in a number of electrolyte disorders. The present review focuses on abnormalities of sodium, potassium, calcium, magnesium, and phosphate. ⋯ These involve stimulation and modulation of other hormones (e.g., antidiuretic hormone, renin-angiotensin system, parathyroid hormone), damage to renal tubules, and, in some cases, a combination of factors. Recognition of these abnormalities is important because their presence may be life threatening or may aggravate the side effects of the drug itself.