title: Paradoxical reaction to epinephrine induced by beta-blockers in an anaphylactic shock induced by penicillin.
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.
authors.affiliation: SAMU 92-SMUR Garches bOccupational Health Department, Raymond Poincaré teaching hospital, AP-HP, Garches, France. sybille.goddet@rpc.aphp.fr
authors.forename: Nathalie-Sybille
authors.initials: NS
authors.lastname: Goddet
authors.forename: Alexis
authors.initials: A
authors.lastname: Descatha
authors.forename: Oliver
authors.initials: O
authors.lastname: Liberge
authors.forename: François
authors.initials: F
authors.lastname: Dolveck
authors.forename: Jérémie
authors.initials: J
authors.lastname: Boutet
authors.forename: Michel
authors.initials: M
authors.lastname: Baer
authors.forename: Dominique
authors.initials: D
authors.lastname: Fletcher
authors.forename: François
authors.initials: F
authors.lastname: Templier
mesh_terms: D000318:Adrenergic beta-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000658:Amoxicillin / Q000009:adverse effects*; D000707:Anaphylaxis / Q000139:chemically induced / Q000188:drug therapy; D000890:Anti-Infective Agents / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004336:Drug Antagonism; D004357:Drug Synergism; D004632:Emergency Medical Services / Q000379:methods; D004638:Emergency Treatment / Q000009:adverse effects / Q000379:methods; D004837:Epinephrine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008487:Medical History Taking; D008508:Medication Errors / Q000009:adverse effects; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012646:Self Administration / Q000009:adverse effects; D014662:Vasoconstrictor Agents / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000318:Adrenergic beta-Agonists; D000319:Adrenergic beta-Antagonists; D000890:Anti-Infective Agents; D014662:Vasoconstrictor Agents; D000658:Amoxicillin; D004837:Epinephrine