Anaphylaxis
In anaphylactic shock the suspected drug should be discontinued immediately.
Epinephrine is given 1:1000, 0.01 ml per kg subcutaneously.
If there is poor peripheral perfusion then 0.01 ml per kg of epinephrine 1:1000 is given IV.
Antihistamines should also be given - diphenhydramine (1 - 2 mg per kg IV or IM)
Steroids also may prevent late phase reactions.
Causes:
Asparaginase is:
- Associated with allergic reactions
- Reactions range from erythema at the injection site to anaphylaxis
- Sensitization to bacterial protein
- Overall incidence with native E coli asparaginase is 15 - 30%
- PEG-asparaginase is less immunogenic
