Potentiated anaphylaxis in patients with drug-induced beta-adrenergic blockade

Robert L. Jacobs, Geoffrey W. Rake, Donald C. Fournier, Robert J. Chilton, William G. Culver, Charles H. Beckmann

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Abstract

Anaphylaxis to known allergens occurred in two patients under treatment for hypertension with propranolol. The clinical course of both cases was similar. Bradycardia associated with an undetectable blood pressure, unusual severity, and sluggish response to treatment were major common factors in which blockade of the beta-adrenergic system may have had a role. Propranolol, a beta-adrenergic antagonist that acts competitively by blocking the adenylate cyclase receptor on efferent cells, is well recognized to cause increased airways resistance in some asthmatic and normal subjects. It is postulated that propranolol potentiated anaphylaxis in these patients by inhibition of adenylate cyclase, resulting in lowered intracellular cyclic AMP and a lowered threshold of mediator release. The bradycardia during profound hypotension is attributed to an unopposed cholinergic action caused by blunting of the normal endogenogy beta-adrenergic response by propranolol.

Original languageEnglish (US)
Pages (from-to)125-127
Number of pages3
JournalThe Journal of Allergy and Clinical Immunology
Volume68
Issue number2
DOIs
StatePublished - Aug 1981

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ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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