Does adrenaline have an important drug interaction with alpha adrenergic receptor blocking drugs?
• Alan Watson, General Practitioner Tranmere South Australia 5073 Dr McLean – Tooke and colleagues list systemic and topical beta adrenergic blockers, tricyclic antidepressants, monoamine oxidase inhibitors and cocaine as having important drug interactions with adrenaline. I suggest that any drug with alpha adrenergic receptor blocking activity should be included. In 1995 I managed a patient with an anaphylactic collapse following a bee sting who was taking the alpha 1 receptor blocker prazosin for hypertension. He appeared to have resistant hypotension following self administered adrenaline by auto-injector and general practitioner administered adrenaline (1). In 1998 a patient from my practice who was on long term thioridazine and amitriptyline had a sudden collapse presumed to be anaphylactic in nature where there was prolonged hypotension. Both of these drugs have a major alpha 1 adrenergic receptor blocking action. The hypotension failed to respond to adrenaline infusions but ther
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