Lasix and Sulpha allergies

[ndilley]

I was curious what people know about people with sulpha allergies recieving lasix. I have read the pts. w/ sulpha allergies and more prone to be allergeric to lasix.

 

[MMiz]

I've heard of this, but it seems as though it's not an issue. That's just a source of information I found off the internet though. We all know that the internet is never wrong

 

[Ridryder911]

One needs to be concerned on how "sensitive" to sulfa products the patient is. Most people that claim to have an "allergy to sulfa", usually only have the usual dermatological effects after taking "Bactrim" or some other sulfa derivatives.

Many people are not aware (including Physicians), Lasix has some components of sulfa, however; I was informed that most Lasix now uses a synthetic derivative instead of true sulfa... (don't know how reliable).

I have yet seen any associated allergies r/t to sulfa and Lasix.

R/r 911

 

[Medic38572]

dupe sorry

 

[Medic38572]

Are most people truly allergic to some drug's or is that some people have an adverse reaction to a drug?.

For every drug given or made there is an adverse reaction doesnt mean that they are allegic to them.

It means one of the adverse reactions the medication has has effected the patient.

Some people think because they take sulfa antibiotics and take other antibiotics on an empty stomach and get sicker than a dog are allergic to them because it made them sick. But this is an adverse reaction if they take them with out eating.

Some med's cause flushing of the skin, sweating ect ect ect but people assume its an allergic reaction. Thats not always the case it could just be a adverse reaction that is usually listed in a nursing pdr.

We all know what a true allergic reaction looks like and how to treat it!

Just to add if someone tells me they are allergic to something I always right it down and wont give anything in that direction.

But working in the ED and out in the field both I got to looking at the allergies people had and would start looking them up in the nursing pdr and sure enough you would see that many of the claims of allergies people had were actually adverse reactions to the medications that the manufacture claimed on some pt's.

Any way sorry just my thoughts. Hope ya dont mind.

 

[Jon]

Good point... I asked that of a patient who was 'allergic' to codine - why? "It makes me feel different and funny" - Umm... yeah... that would be the narcotic opioid effect.

 

[rescuecpt]

Are most people truly allergic to some drug's or is that some people have an adverse reaction to a drug?

When people ask me about allergies, I always say I am allergic to PCN. I have never had anaphylaxis from it, but while uncontrollable vomiting is an "adverse reaction", in my world, I am allergic to anything that produces uncontrollable vomiting.

When I was in the hospital last week by process of elimination I learned that I am allergic to Toradol. While in the ER they gave me 30mg of Toradol and 6mg of morphine. I immediately became itchy on my arm and developed a bright red, raised, rash. My throat started to itch and my tongue started to swell too. Luckily, my transport team (ie, my medic fiance and his medic friend) were standing right there and when I raised my arm and said "look at this, and my mouth feels funny" one of them ran to get the nurse and I got a nice IV bolus diphenhydramine. I was high as a kite for the next few minutes until I passed out, of course.

We ruled out morphine allergy because I got morphine several times more both IV and sub-Q while in the hospital with no reaction. I didn't get toradol again. But now I have to be careful with NSAIDs because I may be allergic to those too after this episode. It's ok though, because I have come to love opiates much more than I ever loved NSAIDs...

 

[Medic38572]

Are you sure you got that morphine S-q or did you get IM?

 

[Ridryder911]

Although morphine can be given all general routes (excluding ET) most physicians are now preferring sub-q for long duration capabilities. It is not unusual to administer 10 to even 15 mg of morphine sub-q. for pain control.

R/r 911

 

[Medic38572]

Really, Thats the first Ive heard of that. Interesting

 

[Medic38572]

Interesting because Ive never heard it done before but after consulting with others I see that it is done usually for the elderly in nursing homes in our area as we all know the effects of IV oR IM morphine to these older people when it hits them.

 

[rescuecpt]

Are you sure you got that morphine S-q or did you get IM?

The first one was supposed to be sub-q but her angle was too high and she basically gave it to me IM. The rest, they made a nice little bubble under my skin.

 

[rescuecpt]

Interesting because Ive never heard it done before but after consulting with others I see that it is done usually for the elderly in nursing homes in our area as we all know the effects of IV oR IM morphine to these older people when it hits them.

Dude, I've never done any drugs (no pot, ecstacy, etc)... so the only high I've ever had was natural or alcohol induced. Lemme tell ya, I LOVED the morphine IV. Sub-q wasn't worth the trouble.

 

[Ridryder911]

If it made a "bubble" then it was incorrectly given and was administered intradermal. Sub-q should not bubble, and one should not aspirate after injecting.

I am sure if it was intradermal, that this slowed down the absorption rate even more so... you might not have felt any of the effects.

The usual treatment is to "load them up" i.e M.S. IV, or Demerol etc.. analgesic, then high dose sub-q to extend the life of the analgesic.

R/r 911

 

[maksim]

Lasix (furosemide) is derivative sulfonamyde?
Probably, it is the reason of a cross allergy?

 

[rescuecpt]

The usual treatment is to "load them up" i.e M.S. IV, or Demerol etc.. analgesic, then high dose sub-q to extend the life of the analgesic.

R/r 911

I was told that they don't give morphine IV "on the floor", only in the ER.

 

[Ridryder911]

That would be up to the physician/practitioner position or orders. It varies from area to area....

R/r 911

 

[rescuecpt]

That would be up to the physician/practitioner position or orders. It varies from area to area....

R/r 911

Of course it does.

 

[fyrdog]

I just want to get this of my chest. I recently read a post on another site that a paramedic had a patient that he wanted to give morpine sulfate but didn't because of a sulfa allergy. sulfates and sulfas are two different things. Chemically they are related but the body breaks them down differently. Sulfa drugs were used as a bacteriostatic. In WW2 they used a powdered form to fight infection on soldiers in combat. Sulfa drugs are also refered to as Sulfanilamides. If you are allergic to sulfa be careful drinking wine as it probable contains sulfanilamides (read the label)

So I your patient is in pain and is allergic to sulfa drugs go ahead and give Morphine Sulfate but don't let them drink the wine.

If you really need to know the chemical make up you will need to consult a chemist or a pharmasist.

 

[Medic38572]

I just want to get this of my chest. I recently read a post on another site that a paramedic had a patient that he wanted to give morpine sulfate but didn't because of a sulfa allergy. sulfates and sulfas are two different things. Chemically they are related but the body breaks them down differently. Sulfa drugs were used as a bacteriostatic. In WW2 they used a powdered form to fight infection on soldiers in combat. Sulfa drugs are also refered to as Sulfanilamides. If you are allergic to sulfa be careful drinking wine as it probable contains sulfanilamides (read the label)

So I your patient is in pain and is allergic to sulfa drugs go ahead and give Morphine Sulfate but don't let them drink the wine.

If you really need to know the chemical make up you will need to consult a chemist or a pharmasist.

What about atropine! Just joking of course