Transfusion Reactions Medication

Updated: Jul 20, 2016
  • Author: S Gerald Sandler, MD, FACP, FCAP; Chief Editor: Emmanuel C Besa, MD  more...
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Medication

Medication Summary

Use an antihistamine to ameliorate allergic reactions to plasma. These agents serve as adjuncts to epinephrine and other standard measures for therapy of anaphylaxis related to transfusions of plasma-containing blood products.

Analgesics and antipyretics reduce fever that is associated with nonhemolytic transfusion reactions. An osmotic diuretic promotes urinary excretion of hemoglobin that results from an acute hemolytic transfusion reaction.

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Antihistamines

Class Summary

Antihistamines prevent histamine response in sensory nerve endings and blood vessels. These agents are more effective in preventing histamine response than in reversing it.

Diphenhydramine hydrochloride (Benadryl, Diphen)

Antihistamine with anticholinergic effects that competes with histamine for receptor sites on effector cells. Among other indications, used to treat urticaria, pruritus, and other histamine-mediated manifestations of allergic reactions to blood products.

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Analgesics and Antipyretics

Class Summary

Analgesics and antipyretics improve patient comfort and reduce fever.

Acetaminophen (Tylenol, Panadol)

Nonopiate, nonsalicylate analgesic and antipyretic. Reduces fever by acting directly on hypothalamic heat-regulating centers, which increase dissipation of body-heat via vasodilation and sweating.

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Osmotic Diuretics

Class Summary

Osmotic agents increase the osmolarity of the glomerular filtrate and induce diuresis. This, in turn, hinders the tubular reabsorption of water, also causing sodium and chloride excretion to increase.

Mannitol injection 20% USP (Osmitrol)

An obligatory osmotic diuretic only slightly metabolized and excreted by the kidney. Induces diuresis by increasing the osmolarity of the glomerular filtrate, thereby hindering tubular reabsorption of water. Excretion of sodium and chloride is also enhanced.

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Vasopressors

Class Summary

Vasopressors are used to reverse the hemodynamic compromise that is associated with anaphylaxis or allergic reaction.

Epinephrine (Epi-Pen, Adrenaline)

A sympathomimetic that activates both alpha receptors and beta receptors. Causes bronchial smooth muscle relaxation and cardiac stimulation.

Dopamine (Intropin)

An immediate precursor to epinephrine, dopamine stimulates dopaminergic, beta-adrenergic, and alpha-adrenergic receptors.

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Loop Diuretics

Class Summary

Diuretics may be used to alleviate volume overload that is caused by transfusion of blood products.

Furosemide (Lasix)

Acts by inhibiting sodium and chloride resorption in the ascending loop of Henle, promoting excretion of sodium, water, chloride, and potassium.

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