The effect of calcium on cardiac anaphylaxis in guinea-pig Langendorff heart preparations

Effect of picumast on histamine release from rat cardiac and peritoneal mast cells

Compound 48/80-induced histamine release (HR) from the isolated perfused rat heart was markedly and significantly inhibited by picumast (PIC), possibly by acting as a calmodulin antagonist (CMA) or membrane stabilizer. Trifluoperazine (TFP, another CMA in clinical use) had a similar effect. However, an action as CMA being the basis of inhibition of HR could not be confirmed in another 'allergy' model, namely HR from rat peritoneal mast cells (RPMC). PIC, TFP and two other CMA, W7 and N-(4-aminobutyl)-5-chloro-1-naphthalenesulfonamide) failed consistently to inhibit 48/80-induced HR from RPMC, and when used on their own at high concentration these compounds caused HR. PIC and TFP also potentiated the heat-induced haemolysis of rat erythrocytes, i.e. lacked membrane stabilizing effect in this model.

Severe anaphylactic reactions outside hospital: etiology, symptoms and treatment

Twenty-seven patients with severe anaphylactic reactions were treated by two anesthesiologist-staffed ambulance helicopters during a 5-year period. All patients had signs of respiratory and/or circulatory failure. Cutaneous symptoms were described in 70% of the patients, gastrointestinal symptoms in 30% and central nervous symptoms in 85%. Wasp sting and drugs were the most common causes. Other etiologies were bee sting, snakebite, nuts and exercise. All patients were provided with advanced pre-hospital medical care. Epinephrine was employed in 78% of the patients. I.v. fluid therapy was started in 77%. Three patients (11%) needed endotracheal intubation. The time-span from onset of symptoms to medical attendance exceeded 45 min in two patients; both died. Of the surviving patients, 23 were hospitalized. The majority had no signs of respiratory or circulatory failure on arrival in the emergency room and needed only observation in the hospital.