title: [Correlation between pholcodine and perioperative anaphylaxis].
abstract: A large number of individuals experiencing anaphylactic reaction to neuromuscular blocking agents have not previously been in contact with them. The search for a substance inducing sensitization to muscle relaxants has led Norwegian and Swedish scientists to pholcodine, a cough suppressant, which is widely used in Europe and worldwide. Ammonium ion is an epitope common to pholcodine and neuromuscular blocking agents and it is the basis of their cross-reactivity. Based on the results of published studies that pointed to a connection of the use of pholcodine and perioperative anaphylactic reaction, pholcodine was withdrawn from the Norwegian market and subsequent research revealed a reduction of anaphylactic reactions in that country. In its latest report, the European Medicines Agency made a decision not to withdraw pholcodine mixtures from the market but it urged further research with the aim to clarify the cross-reactivity between pholcodine and neuromuscular blocking agents.
authors: Department of Clinical Immunology, Pulmonology and Rheumatology, University Department of Internal Medicine, Sveti Duh University Hospital, Zagreb, Croatia. jdumancic@gmail.com
authors: Jelena
authors: J
authors: Dumancić
authors: Asja Stipić
authors: AS
authors: Marković
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000517:prevention & control; D000996:Antitussive Agents / Q000276:immunology*; D003061:Codeine / Q000031:analogs & derivatives* / Q000276:immunology; D003429:Cross Reactions; D006801:Humans; D007167:Immunotherapy; D007431:Intraoperative Complications / Q000276:immunology / Q000517:prevention & control; D009025:Morpholines / Q000276:immunology*; D009466:Neuromuscular Blocking Agents / Q000276:immunology*; D011183:Postoperative Complications / Q000276:immunology / Q000517:prevention & control
chemical_list: D000996:Antitussive Agents; D009025:Morpholines; D009466:Neuromuscular Blocking Agents; C008872:pholcodine; D003061:Codeine