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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.


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









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