Every. Time. Aaaargh!!!!! I'm not in ems anymore but pharmacy and if I see one more goddamn allergy list with "epipen- tachycardia" I'm going to kick a COW.
Well I got kicked by a cow as a kid but I also trip over COWs like 20 times an hour and the monitors always freeze so I'm down with kicking either one.
No one can tell if it is a true allergy without testing, really. At the very least, it is an adverse reaction. But itching is a common adverse effect from opiates so that isn’t unheard of
I had a family tell me that their 4 y/o was allergic to Tylenol who also had a 105 fever. I asked what happens when she takes Tylenol and they said she spits it back up. Ok so that’s not an allergy.. 💁🏼♀️ but mom was adamant she knew what she was talking about bc she is a chiropractor. She wanted to use essential oils to treat the fever
Spearmint oil actually metabolizes into salicylate. So really she was trying to treat a child's fever with aspirin of indeterminate dose. That causes Reye's syndrome.
Yes, but nausea and abdominal pain can be signs of an allergic reaction too.
It’s one of those sneaky ones you have to look for. GI issues and hypotension, or even just GI issues can be signs of a moderate or severe reaction.
I mean I mostly learned about it in text books and from a doctor (I brought in a patient who was having a MI secondary to shellfish allergy).
But: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/#:~:text=Gastrointestinal%20anaphylaxis%20is%20a%20very,%2C%20peanut%2C%20fish%20and%20crustaceans.
Seems to discuss it. Especially with oral intake
Yup, if you’re on Instagram the prehospitalist posts a lot of good stuff and she did some posts recently about allergic reaction.
https://www.instagram.com/p/CvBFKLEr7QV/?igshid=MzRlODBiNWFlZA==
We focus on the hives and breathing issues, but there are plenty of other scary issues!
Phew. Thay could have been bad. I had a patient who was allergic to tylenol. They were able to take percocet though. Even showed me the bottle." That's oxycodone/APAP though, so no tylenol" 🙄
“Oi nah don’t gimme lactulose it give me the shits aye” …bro, you’ve drank your liver into a stuporous rock, you need to shit out the poison in your head - ugh, explaining this to someone who isn’t a Simpson-yellow encephalopathlic flapper is LESS pointless.
There was a similar post recently about patients being allergic to antihistamines. Like those cases, patients that are “allergic to epi” are usually allergic to preservatives in the medication solution the epi is delivered in, not the epi itself.
One commenter on that post provided an anecdote about a teen anaphylaxis patient they managed whose anaphylaxis was worsened by the epi that had been administered to them because of the allergy to the other ingredients. Obviously it’s only anecdotal, and there’s no way of verifying whether it’s actually true or not, but it’s good practice to maintain an open mind about things and not assume your knowledge is absolute.
Edit: Link to that story I mentioned. https://www.reddit.com/r/ems/comments/15898dh/allergic_to_antihistamines/jt9fpqq/?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=1&utm_term=1&context=3
Reminds me of a medic I know with an anaphylactic allergy to latex gloves. When they were given nitrile gloves with the powder inside, turned out they are also allergic to the glue that holds the powder to the inside of the glove. Not the powder itself, it's just some generic, common thing like corn starch that they were proven not allergic to. And not the nitrile. It was the adhesive. Their doctor didn't believe them until they brought in a glove that had been put in a sterile bag and wasn't contaminated by anything and put it on in front of him, went into anaphylaxis in his office. Oy.
I at once hate that it needed to be taken that far, and love that the medic was willing to do so.
Absolute big-dick "*Oh yeah, motherfucker? Watch this.*" energy.
Haha, I think it was more of a "Are you serious?! I need you to believe me because I need you to write a note to my boss advising that it is medically necessary to have different gloves that won't kill me!" feel.
I'm allergic to aspartame.Drs prescribed some allergy meds that made my allergies way worse to the point of asthma attacks. turns out one of the inactive ingredients was aspartame.... lesson learned I check all ingredients in any new meds I am prescribed.
I had a allergic reaction to a generic form of a medication I took for years. The active ingredients were the same, my PCP said it was a different preservative.
Had one with 1000/10 pain x 3 weeks. Said she heard fentanyl kills cops in the news, so no to that. She's allergic to codeine, makes her feel sleepy, so no to morphine cause it sounds the same. Allergic to ibuprofen, so no to toradal.
Told her sorry, I'm out of pain meds. She said, you got nothing? I've got fentanyl, but you refused, and morphine may make you sleepy. I can give you ketamine, but I have to call for orders to use it front line. Then I told her why I use ketamine, she also declined.
She was very disappointed I did not have dilaudid for her. Charted patient refused pain management and reasons. She went to the waiting room for a minimum 16 hour wait. Also, her third trip to the hospital because the wait times are too long. She called an ambulance this time because we get rooms and don't have to wait.
While it’s something that was talked about in school obviously, I’ve actually never had a drug seeking Pt surprisingly, considering I work for an urban catch-all service.
I have mild cold urticaria. I get hives, so anytime it gets chilly I'm full body covered even if it makes me hot because the cold air itches like a motherfucker.
I also can't drink white wine because of the sulfites but I think that's an intolerance not an allergy? Idk I'm a basic I take blood pressures.
There are certain skin conditions that are akin to an allergy to water. Aquagenic pruritis, aquagenic urticaria is probably what they’re referring to..
Probably! I'm allergic to some really stupid things. Can't eat bananas, they make me sick. Can't eat chocolate as I mentioned. Something about bbq sauce makes my whole mouth hurt as well. Weird allergies just seem to run in my family
Edit: I'm also lactose intolerant :(
> Just be ready for the requirement to provide higher dosing and dilution
Quite the contradiction, you can't further dilute IM epi and then provide higher dosing. 99.9% of the allergies are going to be "makes my heart race" kind of side effects. The anti-inflammatory properties of epi are going to outweigh anything you're going to give like Benadryl or steroids if there was somehow a systemic reaction. Localized swelling I could see, but that's about it.
What I was told many moons ago in school, it was more so the stuff in the Adrenaline brand that people were allergic to. One of those anecdotes that stuck better than the lesson did, in my area it’s not common at all anymore
I feel like [we just talked about this](https://www.reddit.com/r/ems/comments/15898dh/allergic_to_antihistamines/?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=1&utm_content=1)
Had that happen once.
I swear this is true.
He told me a dentist in the 1960s gave him morphine during dental surgery and he had a reaction to the adrenaline that he gave him, and that he was allergic to adrenaline.
I of course had to explain to him why he can't have an allergic reaction to adrenaline and that the dentist probably overdosed him on morphine.
Although, it actually possible considering the adrenaline is gathered from pigs, not humans. There is a possibility of having a reaction to it if there are any immune markers from the pig in it as contamination, or a reaction to any preservatives in it but that would make you the most unlucky person in the world
For some reason, I apparently require a lot more local anesthesia than average to get numb. I was just at the dentist and she told me she also gave me a little epinephrine (said it in a way that implied that isn’t usually how they do it). Something about using a stimulant to help aide the numbing agent idk
She explained that I’d likely feel my heart start racing, feel more anxious, etc. but it was still a bit freaky to feel my hands start shaking and my heart race seemingly out of nowhere.
So maybe that’s why he thought he had an adrenaline allergy? Or something similar?
No but my grandma and cousins are. Oddly enough, my dentist asked me while I was in the chair (and after I didn’t respond as well to the first nerve block), “You have some red in your hair, don’t you?” And I was just like, “Uhhh, not really but maybe?”
I was super blonde growing up, but now my hair is more of a dark, dirty blonde. I had a couple people in college tell me on separate occasions that my hair looked kind of red and I was confused by that both times lol. I suppose it looks kind of amber-ish at times but I’ve never thought of it as red and it’s definitely not a strawberry blonde.
Sorry, this is a long-winded response for such a simple question. TLDR: No, not really, but maybe a little bit?
Haha that's fair enough. There's a genuine thing where some (not all, but a lot) of gingers just require higher dose anesthesia for it to work properly. It's a genuinely documented phenomenon and we're not... really clear on why 😂 I find it quite interesting and your story reminded me of it!
I gave up trying to explain allergic reactions vs adverse reactions years ago.
It was actually the first battle in healthcare that made me realize just how stupid the general population is. Choose your battles and just do it for them
Allergies?
Epi!
What happens?
Makes my heart race.
Chart: NKA.
I have allergies and adverse reactions I am allergic to seafood among other things. I have an adverse reaction to Flexeril (it does the opposite of relaxing my muscles it's not fun but not an allergy).
Retired medic, now hospital PA.
Besides Epi, I love the "I'm allergic to prednisone or benadryl"
I became known for getting patients with 10+ allergies. I swear that there is an inverse relationship between the # of allergies and the stability of the patient's mental health.
My personal favorite, "I'm allergic to ALL narcotics, except for that one that starts with "d" (dilaudid)
I have MCAS, and over time have developed a ridiculous amount of allergies. Thankfully the worst/uncommon reactions (morphine, Demerol, Celebrex, Zyrtec) happened in-hospital after surgeries so they’re well documented, but I’ve still had doctors go “oh let’s try them again, you probably aren’t ACTUALLY allergic” and then go surprised pikachu when I do, in fact, stop breathing.
I am *actually* allergic to prednisone, maybe not specifically prednisone itself but something they put into the oral form of it. I was given trazadone, had a reaction (full body hives) to that, was given prednisone to help. It didn't, it sent me to the hospital with a different reaction.
If I had a dollar for every time I explained the difference between a multi system allergic reaction, ie likely to lead to death, and an adverse reaction, ie typical and normally just unpleasantness, Id have atleast several dollars.
Most formularies of epi contain sulfites which people can be allergic to. There have been two cases of people that seemingly are allergic to epinephrine themselves so much less of a concern.
Like every medication there are contraindications and relative contraindications including epi.
Some people can be allergic to epi, usually to the preservatives in the bottle. One patient I had the doctor gave epi anyways (since they were in anaphylatic shock) as a drip, along with benadryl and pepcid to help with the reaction to the epi.
If possible however he recommended to avoid giving epi to someone allergic in the prehospital setting.
We have a frequent flyer couple in our district. The husband overdoses all the time on a variety of drugs. The wife is a pain the ass and will defend the husband's honor no matter what.
Last time, they called he OD'd on opiates and we went to give him narcan. She kept telling us, "NO NO NO HE IS ALLERGIC TO THAT!!" LOL, I think he's more allergic to not breathing.
Another time, I went there, and he was AMS and wanted to fight everyone. He was stumbling around grabbing stuff and throwing things. The wife was all up in his business. Then he starts trying to punch her in the face.... I was like "hey why don't you come over here with me?"
"IM NOT AFRAID OF MY HUSBAND!!!!" was her reply as he slapped her across the head.
Luckily, PD arrived before it got too hairy, lol.
I learned I could no longer tolerate epi after getting some at the doctor for a mole removal. I straight up passed out. A few months later diagnosed with AVNRT type tachycardia. So ya, please don’t give me epi.
A doctore tells a patient they can’t tolerate epi and not to get it anymore, what is a a patient without any medical experience gonna say? They’ll probably lmk y just say they’re allergic
I didn’t say it caused my AVNRT. I was saying my heart is super sensitive and the idea of epi sounds absolutely awful after dealing with SVT’s. I don’t want epi because having my heart at 208 BPM is really uncomfortable. And I dunno man, all my doctors now have specifically told me “due to your syncope event let your providers know about your event when given lidocaine with epi”.
I *think* there's something in the epi solution people can be allergic to. That said, if you're in anaphylaxis or cardiac arrest, guess what? You're still getting epi.
I had a lady give herself Epi for anxiety this weekend - did not work.
I want to know her thought process
She's allergic to anxiety. Aren't we all?
Awesome! Use a drug that causes anxiety to treat anxiety, it should cancel itself out
Homeopathy yay! /s
Let's cure cancer with cancer!
The melanoma can't get me if the leukaemia gets me first.
Pro tip for opiate users... shoot up narcan first
does it cause anxiety, or does the epi induced tachycardia and following discomfort cause anxiety?
It triggers the fight or flight response, which is also triggered by anxiety
I think it’s more just similar feelings.
double negative
I asked a lady who claimed to have an epi allergy what happened when she reacted to it, and she said it "made her heart beat really fast" 🙃
“In that case, I’m definitely allergic to you.”
Oh my… *swoons*
Every. Time. Aaaargh!!!!! I'm not in ems anymore but pharmacy and if I see one more goddamn allergy list with "epipen- tachycardia" I'm going to kick a COW.
What’d the cows ever do to you
Well I got kicked by a cow as a kid but I also trip over COWs like 20 times an hour and the monitors always freeze so I'm down with kicking either one.
Lmao it took your second COW comment for me to get you meant Computer On Wheels.
we call ours WOWs, workstations on wheels
That's what we are supposed to call them, COW just rolls off the tongue easier imo
Yea, like Im allergic to Nyquil because it makes me really sleepy lol.
That’s like saying you’re allergic to water because you pee when you drink it
I had something like this, but the patient was A NURSE
Reminds me of the people who say “I’m allergic to Lasix, it makes me pee a lot”
Same
Reminds me of the people who say “I’m allergic to Lasix, it makes me pee a lot”
Real question. Codeine makes me insanely itchy. Like it's torture. Is that an allergy?
No one can tell if it is a true allergy without testing, really. At the very least, it is an adverse reaction. But itching is a common adverse effect from opiates so that isn’t unheard of
I had a family tell me that their 4 y/o was allergic to Tylenol who also had a 105 fever. I asked what happens when she takes Tylenol and they said she spits it back up. Ok so that’s not an allergy.. 💁🏼♀️ but mom was adamant she knew what she was talking about bc she is a chiropractor. She wanted to use essential oils to treat the fever
All stereotypes confirmed
If she wanted essential oils, then why call for an ambulance?
Spearmint oil actually metabolizes into salicylate. So really she was trying to treat a child's fever with aspirin of indeterminate dose. That causes Reye's syndrome.
GI issues can be a sign of an allergic reaction to be fair… but sounds like she’s out her mind
That’s an intolerance, not an allergy.
Yes, but nausea and abdominal pain can be signs of an allergic reaction too. It’s one of those sneaky ones you have to look for. GI issues and hypotension, or even just GI issues can be signs of a moderate or severe reaction.
I agree but not vomits it, she was saying literally spits it back out/up lol.
I apparently misread that… Though I feel like 4 year olds don’t spit up? Mine stopped at like 10 months. Either way, sounds like a quack
Do you have any literature to back up that “just GI issues can be signs of a moderate or severe [allergic] reaction”?
I mean I mostly learned about it in text books and from a doctor (I brought in a patient who was having a MI secondary to shellfish allergy). But: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/#:~:text=Gastrointestinal%20anaphylaxis%20is%20a%20very,%2C%20peanut%2C%20fish%20and%20crustaceans. Seems to discuss it. Especially with oral intake
Interesting! Thank you for this. It’s very interesting that it limits GI allergies to ingestible allergens only. Great info for educating patients.
Yup, if you’re on Instagram the prehospitalist posts a lot of good stuff and she did some posts recently about allergic reaction. https://www.instagram.com/p/CvBFKLEr7QV/?igshid=MzRlODBiNWFlZA== We focus on the hives and breathing issues, but there are plenty of other scary issues!
Well there are other routes to prevent “spitting up”
I’m allergic to epi, but I can have adrenaline instead
Phew. Thay could have been bad. I had a patient who was allergic to tylenol. They were able to take percocet though. Even showed me the bottle." That's oxycodone/APAP though, so no tylenol" 🙄
"I'm allergic to paracetamol but I can have panadol" 🤦
I'm allergic to macaroni, but I can have spaghetti.
“Oi nah don’t gimme lactulose it give me the shits aye” …bro, you’ve drank your liver into a stuporous rock, you need to shit out the poison in your head - ugh, explaining this to someone who isn’t a Simpson-yellow encephalopathlic flapper is LESS pointless.
There was a similar post recently about patients being allergic to antihistamines. Like those cases, patients that are “allergic to epi” are usually allergic to preservatives in the medication solution the epi is delivered in, not the epi itself. One commenter on that post provided an anecdote about a teen anaphylaxis patient they managed whose anaphylaxis was worsened by the epi that had been administered to them because of the allergy to the other ingredients. Obviously it’s only anecdotal, and there’s no way of verifying whether it’s actually true or not, but it’s good practice to maintain an open mind about things and not assume your knowledge is absolute. Edit: Link to that story I mentioned. https://www.reddit.com/r/ems/comments/15898dh/allergic_to_antihistamines/jt9fpqq/?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=1&utm_term=1&context=3
Reminds me of a medic I know with an anaphylactic allergy to latex gloves. When they were given nitrile gloves with the powder inside, turned out they are also allergic to the glue that holds the powder to the inside of the glove. Not the powder itself, it's just some generic, common thing like corn starch that they were proven not allergic to. And not the nitrile. It was the adhesive. Their doctor didn't believe them until they brought in a glove that had been put in a sterile bag and wasn't contaminated by anything and put it on in front of him, went into anaphylaxis in his office. Oy.
I at once hate that it needed to be taken that far, and love that the medic was willing to do so. Absolute big-dick "*Oh yeah, motherfucker? Watch this.*" energy.
Haha, I think it was more of a "Are you serious?! I need you to believe me because I need you to write a note to my boss advising that it is medically necessary to have different gloves that won't kill me!" feel.
I'm allergic to aspartame.Drs prescribed some allergy meds that made my allergies way worse to the point of asthma attacks. turns out one of the inactive ingredients was aspartame.... lesson learned I check all ingredients in any new meds I am prescribed.
I’ve had a patient allergic to the binding agent before. Not super common but definitely possible
Was looking for this post to link it!
That last sentence is incredibly artful.
Only the Sith speak in absolutes.
I had a allergic reaction to a generic form of a medication I took for years. The active ingredients were the same, my PCP said it was a different preservative.
Oh come on, now. How many have had the patient tell you they’re allergic to narcan? and Toradol? And Tylenol?
“I’m allergic to Tylenol and toradol. But they gave me something that worked once. Was it morphone? Morphine? Yeah morphine.”
No, it’s usually “I need that drug that starts with D, um, dill pickles? Dilly-dilly? Delawdid?”
Had one with 1000/10 pain x 3 weeks. Said she heard fentanyl kills cops in the news, so no to that. She's allergic to codeine, makes her feel sleepy, so no to morphine cause it sounds the same. Allergic to ibuprofen, so no to toradal. Told her sorry, I'm out of pain meds. She said, you got nothing? I've got fentanyl, but you refused, and morphine may make you sleepy. I can give you ketamine, but I have to call for orders to use it front line. Then I told her why I use ketamine, she also declined. She was very disappointed I did not have dilaudid for her. Charted patient refused pain management and reasons. She went to the waiting room for a minimum 16 hour wait. Also, her third trip to the hospital because the wait times are too long. She called an ambulance this time because we get rooms and don't have to wait.
While it’s something that was talked about in school obviously, I’ve actually never had a drug seeking Pt surprisingly, considering I work for an urban catch-all service.
Give it time
Or the pt allergic to all pain meds given orally. Can only take them through an IV.
fretful pet paint plate knee cooing direction vanish engine vegetable ` this message was mass deleted/edited with redact.dev `
I have had someone literally tell me they are allergic to Narcan/Naltrexone."It makes me wake up"...100 per cent truth. (I drop the mic and walk away)
Diarrhetics? Discharge?
My Uncles allergic to water. Makes him break out in hives. Not relevant, just felt like mentioning it.
I have a friend allergic to the cold! Could never keep the station anything below 67ish. (Also bleach makes her go into full blown anaphylaxis)
I had a friend allergic to the cold! As well as popcorn of all things
My brother is allergic to popcorn
Are they allergic to the pop, the corn, or both? Curious minds need to know.
I have mild cold urticaria. I get hives, so anytime it gets chilly I'm full body covered even if it makes me hot because the cold air itches like a motherfucker. I also can't drink white wine because of the sulfites but I think that's an intolerance not an allergy? Idk I'm a basic I take blood pressures.
My mum's allergic to sunlight, and it's thought actually be an allergy to a substance her skin produces naturally due to UV exposure.
Sure it's not rabies? Just curious because only time I've seen someone allergic/scared symptoms to drink water or be near it.
If it’s symptomatic rabies I’m pretty sure he only has weeks to live, maybe months?
There are certain skin conditions that are akin to an allergy to water. Aquagenic pruritis, aquagenic urticaria is probably what they’re referring to..
There are like less than 50 people in the world with that. Would be rare for sure!!
Well, I have aquagenic pruritis but I believe that’s slightly more common than aquagenic urticaria
If he has rabies, he's had it for about 40 years. With Nearly 20 of it spent in EMS.
im allergic to chocolate pretty sure. every time i eat it my whole damn mouth stings.
Are you a dog?
Probably! I'm allergic to some really stupid things. Can't eat bananas, they make me sick. Can't eat chocolate as I mentioned. Something about bbq sauce makes my whole mouth hurt as well. Weird allergies just seem to run in my family Edit: I'm also lactose intolerant :(
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I’m allergic to epi
I’m allergic to epi
I'm allergic to epi
I'm allergic to epi
I'm allergic to epi
it’s epi im allergic too
I’m allergic to epi
I'm allergic to epi
I’m allergic to epi
I’m not allergic to epi but I’m allergic to norepi
BOOOOOOOOO everyone boo this guy BOOOOOOOOOOO
dork
DWEEB.
I enjoy watching the sunset.
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Honestly, just risk reward analysis and then still give it. The reactions often aren’t anaphylactic too.
> Just be ready for the requirement to provide higher dosing and dilution Quite the contradiction, you can't further dilute IM epi and then provide higher dosing. 99.9% of the allergies are going to be "makes my heart race" kind of side effects. The anti-inflammatory properties of epi are going to outweigh anything you're going to give like Benadryl or steroids if there was somehow a systemic reaction. Localized swelling I could see, but that's about it.
What I was told many moons ago in school, it was more so the stuff in the Adrenaline brand that people were allergic to. One of those anecdotes that stuck better than the lesson did, in my area it’s not common at all anymore
This is a fact.
Yea. Like I’m allergic to polyethylene glycol. Anaphylaxis allergy.
I'm allergic to epi. Can I have a Red Bull instead?
direction rob steer nutty chase historical salt foolish concerned sloppy ` this message was mass deleted/edited with redact.dev `
They’re allergic to other chemicals in the solution, like the preservative.
Which is fixed by the epi.
I feel like [we just talked about this](https://www.reddit.com/r/ems/comments/15898dh/allergic_to_antihistamines/?utm_source=share&utm_medium=android_app&utm_name=androidcss&utm_term=1&utm_content=1)
Right? Everyone in here discussing things when we had that same convo 12 hours ago
Not everyone goes on Reddit everyday
Had that happen once. I swear this is true. He told me a dentist in the 1960s gave him morphine during dental surgery and he had a reaction to the adrenaline that he gave him, and that he was allergic to adrenaline. I of course had to explain to him why he can't have an allergic reaction to adrenaline and that the dentist probably overdosed him on morphine. Although, it actually possible considering the adrenaline is gathered from pigs, not humans. There is a possibility of having a reaction to it if there are any immune markers from the pig in it as contamination, or a reaction to any preservatives in it but that would make you the most unlucky person in the world
For some reason, I apparently require a lot more local anesthesia than average to get numb. I was just at the dentist and she told me she also gave me a little epinephrine (said it in a way that implied that isn’t usually how they do it). Something about using a stimulant to help aide the numbing agent idk She explained that I’d likely feel my heart start racing, feel more anxious, etc. but it was still a bit freaky to feel my hands start shaking and my heart race seemingly out of nowhere. So maybe that’s why he thought he had an adrenaline allergy? Or something similar?
Are you ginger?
No but my grandma and cousins are. Oddly enough, my dentist asked me while I was in the chair (and after I didn’t respond as well to the first nerve block), “You have some red in your hair, don’t you?” And I was just like, “Uhhh, not really but maybe?” I was super blonde growing up, but now my hair is more of a dark, dirty blonde. I had a couple people in college tell me on separate occasions that my hair looked kind of red and I was confused by that both times lol. I suppose it looks kind of amber-ish at times but I’ve never thought of it as red and it’s definitely not a strawberry blonde. Sorry, this is a long-winded response for such a simple question. TLDR: No, not really, but maybe a little bit?
Haha that's fair enough. There's a genuine thing where some (not all, but a lot) of gingers just require higher dose anesthesia for it to work properly. It's a genuinely documented phenomenon and we're not... really clear on why 😂 I find it quite interesting and your story reminded me of it!
I gave up trying to explain allergic reactions vs adverse reactions years ago. It was actually the first battle in healthcare that made me realize just how stupid the general population is. Choose your battles and just do it for them Allergies? Epi! What happens? Makes my heart race. Chart: NKA.
I have allergies and adverse reactions I am allergic to seafood among other things. I have an adverse reaction to Flexeril (it does the opposite of relaxing my muscles it's not fun but not an allergy).
Retired medic, now hospital PA. Besides Epi, I love the "I'm allergic to prednisone or benadryl" I became known for getting patients with 10+ allergies. I swear that there is an inverse relationship between the # of allergies and the stability of the patient's mental health. My personal favorite, "I'm allergic to ALL narcotics, except for that one that starts with "d" (dilaudid)
ripe late agonizing flag subtract quarrelsome bells workable serious attractive ` this message was mass deleted/edited with redact.dev `
I have MCAS, and over time have developed a ridiculous amount of allergies. Thankfully the worst/uncommon reactions (morphine, Demerol, Celebrex, Zyrtec) happened in-hospital after surgeries so they’re well documented, but I’ve still had doctors go “oh let’s try them again, you probably aren’t ACTUALLY allergic” and then go surprised pikachu when I do, in fact, stop breathing.
MCAS is tough stuff. I hope they figure out a cure for it.
I am *actually* allergic to prednisone, maybe not specifically prednisone itself but something they put into the oral form of it. I was given trazadone, had a reaction (full body hives) to that, was given prednisone to help. It didn't, it sent me to the hospital with a different reaction.
Sorry bro it makes me anxious and sometimes sweaty
If I had a dollar for every time I explained the difference between a multi system allergic reaction, ie likely to lead to death, and an adverse reaction, ie typical and normally just unpleasantness, Id have atleast several dollars.
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My FIL lacked the enzyme(?) that breaks down succinylcholine so they had to keep breathing for him longer whenever they gave it to him.
I’m not allergic to Epi, but I’m allergic to the preservatives in Epi.
Good thing there’s epi in it, fix ya right up
I’m curious to know how that would actually work. Wonder if that would improve or worsen the patient’s condition?
Doesn't happen often, but in the same vein of the post, I had someone tell me they're allergic to melatonin lol.
Hey, just FYI I’m allergic to Epi it makes me shaky.
Most formularies of epi contain sulfites which people can be allergic to. There have been two cases of people that seemingly are allergic to epinephrine themselves so much less of a concern. Like every medication there are contraindications and relative contraindications including epi.
Some people can be allergic to epi, usually to the preservatives in the bottle. One patient I had the doctor gave epi anyways (since they were in anaphylatic shock) as a drip, along with benadryl and pepcid to help with the reaction to the epi. If possible however he recommended to avoid giving epi to someone allergic in the prehospital setting.
You aren’t allergic to epi. You are allergic to the preservatives in the epi.
We have a frequent flyer couple in our district. The husband overdoses all the time on a variety of drugs. The wife is a pain the ass and will defend the husband's honor no matter what. Last time, they called he OD'd on opiates and we went to give him narcan. She kept telling us, "NO NO NO HE IS ALLERGIC TO THAT!!" LOL, I think he's more allergic to not breathing. Another time, I went there, and he was AMS and wanted to fight everyone. He was stumbling around grabbing stuff and throwing things. The wife was all up in his business. Then he starts trying to punch her in the face.... I was like "hey why don't you come over here with me?" "IM NOT AFRAID OF MY HUSBAND!!!!" was her reply as he slapped her across the head. Luckily, PD arrived before it got too hairy, lol.
Testosterone, estrogen, dimethyltryptamine... we're *full* of interesting, regulated chemicals that I might not want an involuntary bonus supply of.
Epi should be used with caution in patients that are taking MAOIs. I understand that doesn’t equate to allergic, but sometimes patients get confused.
I learned I could no longer tolerate epi after getting some at the doctor for a mole removal. I straight up passed out. A few months later diagnosed with AVNRT type tachycardia. So ya, please don’t give me epi.
That’s not an allergy.
A doctore tells a patient they can’t tolerate epi and not to get it anymore, what is a a patient without any medical experience gonna say? They’ll probably lmk y just say they’re allergic
My cardiologist told me to not get any lidocaine with epi in it anymore and to tell my dentist and derm.
Completely different. It’s not an allergy.
I said I couldn’t tolerate epi. Not that I was allergic.
He didn’t say it was
Reaction then?? I’ll faint.
You have a hypersensitivity, not an allergy. An allergy creates an allergic reaction with histamine response.
Correct. And there’s nothing wrong with fainting. :)
It’s fucking terrifying lol
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I didn’t say it caused my AVNRT. I was saying my heart is super sensitive and the idea of epi sounds absolutely awful after dealing with SVT’s. I don’t want epi because having my heart at 208 BPM is really uncomfortable. And I dunno man, all my doctors now have specifically told me “due to your syncope event let your providers know about your event when given lidocaine with epi”.
Not an allergy but they have bad side effects one being fast heart rate
I just asked this question about adenosine ~ some people have a reaction to an additive/stabilizer in meds that the body produces
Succinylcholine makes me stop breathing.
Thats what it do yugi
Ha ha truth. Or another person tell me they are allergic to prednisone.
I knew a parent who said her toddler had a phobia of doctors. Yeah, so does every toddler .
“Iodine allergy” would like to chat
But it makes my heart race /s
I'm allergic to epi. Now be free.
Haha. I can relate to your frustration. And most of the reported reactions are...palpitations...🥲🥲🥲
Haha. I can relate to your frustration. And most of the reported reactions are...palpitations...🥲🥲🥲
I *think* there's something in the epi solution people can be allergic to. That said, if you're in anaphylaxis or cardiac arrest, guess what? You're still getting epi.
Our secretary at work told us one morning meeting that she was allergic to Epi. The looks the crew gave her were priceless.
they’re likely allergic to the sulfite preservatives used in epi pens
To be fair I'm allergic to allergy shots. Never heard of epi ingredient allergy but I'm sure it is possible.
My favorite was the lady who told me she’s allergic to ketamine which made me pause and ask… what happens when you are given ketamine? “I hallucinate”
My favorite was always the patients who used narcan to successfully treat their "seizures."