Steroid allergy

[med7343]

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Hi team, I have a patient who has anaphylactic reaction to an IM steroid 10 years ago- details unknown but good history including ICU stay for 3 days.

Do you guys have allergist that test for Depomedrol/ decadron/ Kenalog?
What other options for epidural

Thanks

 

[Laryngospasm]

Probably a preservative reaction. Is the epidural worth the risk really though? While true reactions are rare with a case like this not sure it’s worth the risk.

 

[DODOCSS]

disregarded once 10yrs ago, ended with prototypical liberal overreaction, never saw patient again

THM, fibro/IC/PTSD patient = not worth it

 

[Ducttape]

disregarded once 10yrs ago, ended with prototypical liberal overreaction, never saw patient again

THM, fibro/IC/PTSD patient = not worth it

what does that question have to do with politics? am I missing something here?

 

[bedrock]

Might be because liberals assume they are so much smarter than the unwashed masses and so they feel they have the right to tell them how they should live their lives in this free country.

Likewise, my most liberal patients tend to be the ones who think they are as knowledgeable as a doctor, despite only having only studied art history at middlebury....

 

[ateria radicularis magna]

Might be because liberals assume they are so much smarter than the unwashed masses and so they feel they have the right to tell them how they should live their lives in this free country.

Likewise, my most liberal patients tend to be the ones who think they are as knowledgeable as a doctor, despite only having only studied art history at middlebury....

Fart noise

 

[Ducttape]

or maybe certain conservatives are so fixated on politics that it infects every part of their lives....

what a sad way to live.

 

[bedrock]

or maybe certain conservatives are so fixated on politics that it infects every part of their lives....

what a sad way to live.

no one lives their life in politics every day, all day, like hard core liberals. They literally can't look at the blue sky without thinking of how it is somehow less blue for women, minorities, etc...., it obscurs all rational thought.

 

[SSdoc33]

no one lives their life in politics every day, all day, like hard core liberals. They literally can't look at the blue sky without thinking of how it is somehow less blue for women, minorities, etc...., it obscurs all rational thought.

rational thought like only liberals have reactions to steroid? nonsense

 

[bedrock]

rational thought like only liberals have reactions to steroid? nonsense

That's not what I meant. And you clearly sidestepped my actual statement about liberals seeing everything through sex and race.

Anyway, I don't plan to continue this thread as I don't relish politically bickering, because I'm not a hardcore liberal or conservative. Neither are the majority of people in the US. Most citizens are moderate, not hardcore republicans or hardcore democrats. Personally, I feel the extremes of both parties are nuts.

Midterms show moderates are far from being politically extinct

Governing and running in a spirit of “radical pragmatism” is the best bet for delivering the results that Americans crave.

thehill.com

A plurality of our respondents — 44 percent — called themselves “moderate,” versus 24 percent liberal and 32 percent conservative. Independents are overwhelming moderate (62 percent), potentially an exceptionally important as we look ahead to 2020

 

[SSdoc33]

That's not what I meant. And you clearly sidestepped my actual statement about liberals seeing everything through sex and race.

Anyway, I don't plan to continue this thread as I don't relish politically bickering, because I'm not a hardcore liberal or conservative. Neither are the majority of people in the US. Most citizens are moderate, not hardcore republicans or hardcore democrats. Personally, I feel the extremes of both parties are nuts.

Midterms show moderates are far from being politically extinct

Governing and running in a spirit of “radical pragmatism” is the best bet for delivering the results that Americans crave.

thehill.com

A plurality of our respondents — 44 percent — called themselves “moderate,” versus 24 percent liberal and 32 percent conservative. Independents are overwhelming moderate (62 percent), potentially an exceptionally important as we look ahead to 2020

i did sidestep your statement because i dont believe it to be true.

you also posted a clear example of political "bickering" but then state that you hate political bickering. o.........kay...........

if you are indeed a moderate like you claim, then you will vote for a moderate in the primary and in the general. that means Klobuchar, biden, bloomberg, or buttigieg. it does not mean DJT. lets hope your voting record is less hypocritical than your last few posts.....

 

[bedrock]

i did sidestep your statement because i dont believe it to be true.

you also posted a clear example of political "bickering" but then state that you hate political bickering. o.........kay...........

if you are indeed a moderate like you claim, then you will vote for a moderate in the primary and in the general. that means Klobuchar, biden, bloomberg, or buttigieg. it does not mean DJT. lets hope your voting record is less hypocritical than your last few posts.....

Moderates don't vote in primaries. Didn't you know that? Only political zealots vote in the primary, thus confirming where you stand.

I didn't vote for trump last time, this time, it would depend on who wins the nomination. A moderate democrat is a reasonable choice. Would never vote for a socialist/communist like Sanders or Warren.

 

[gaseous_clay]

Moderates don't vote in primaries. Didn't you know that? Only political zealots vote in the primary, thus confirming where you stand.

I didn't vote for trump last time, this time, it would depend on who wins the nomination. A moderate democrat is a reasonable choice. Would never vote for a socialist/communist like Sanders or Warren.

To continue taking this thread off the rails, while I cannot stand this modern Trump-sycophantic version of the GOP, I just don’t understand how any moderate could get energized by the extremist policies of Warren or Sanders, who both seem completely out of touch with the average voter. I really hope Dems select a candidate who can unify all their warring factions. Until then, get ready for MAGA 2.0.

 

[Ducttape]

Getting back to the OP, it appears that depomedrol and hydrocortisone are the more likely culprits - or the additives. Dexamethasone seems to be least implicated (technically preservative free...).

I wouldn't recommend an epidural, but even so,skin testing might be beneficial long term, and I’d ask for testing to depo and dex...

 

[med7343]

Phew, thanks- been waiting for a clinical response.

 

[Ducttape]

fwiw, if you do skin testing, make sure you give the allergist a bottle of the depo and dex that you would use for the procedure. be very specific, so if you do use it, you can be more sure that the drug you give didn't doesn't cause the anaphylaxis

 

[olafa]

Does not really make sense For allergic reactions like contrast they recc pretreatment with steroid 1 d, 12 hours and 2 hr prior ??? has to be something else. possibly preservative