Allergy to epi

[T-Bird78]

What do you say to pts who say they're allergic to epinephrine? Typically it's a story of a bad experience at a dental appointment and the dentist tells them they're allergic to epi and can't ever have it again, but when I point out it's more likely an allergy to the lidocaine and not the epi, they get quiet. I'll remind them that it's supposed to make your heart race and epi is adrenaline, like the panicky feeling when a car cuts you off too closely in traffic, only times 1000. Yesterday I had a pt say they were sensitive to epi due to mitral valve prolapse and it gets the heart rate up too high. That makes sense to me, but all the other ones just don't.

[BuckyBadgerRN, ASN, RN]

On an ems call once I had a nurse tell me not to give her neighbor with chest pain nitro because she was allergic. When we asked what happened when she took it, the nurse said "she gets a headache and her ears ring". Hand to god.

[nursefrances, BSN, RN]

On an ems call once I had a nurse tell me not to give her neighbor with chest pain nitro because she was allergic. When we asked what happened when she took it, the nurse said "she gets a headache and her ears ring". Hand to god.

Are you SURE she was a nurse? Or did she just say she is a nurse? (Because we've all read those "I'm a nurse" threads.)

[BuckyBadgerRN, ASN, RN]

Nope, really truly an RN. She ended up "guest lecturing" in one of my nursing classes a few years later and I had such a hard time even listening to her, I was having serious flashbacks!!

Are you SURE she was a nurse? Or did she just say she is a nurse? (Because we've all read those "I'm a nurse" threads.)

[Here.I.Stand, BSN, RN]

Nope, really truly an RN. She ended up "guest lecturing" in one of my nursing classes a few years later and I had such a hard time even listening to her, I was having serious flashbacks!!

I've got to ask...what was her lecture on, if you remember?? I'd have so much trouble taking her seriously.

[BuckyBadgerRN, ASN, RN]

If I remember right, it was congenital conditions. See? I can't even remember for sure!!!

[canned_bread]

Frequently my patients say they are "allergic" to a medication, when in actual fact their symptoms were side-effects, not allergies. The most common is nausea and vomiting from drugs (not actually allergy), and hallucinations from morphine. These are all side effects. I educate my patients about the difference and tell them the term is "sensitive", or they can say "I do not want this drug because of...".

A true allergy is breathing difficulties, swelling, itchyness, rash etc.

[T-Bird78]

I always ask what the "allergic reaction" to a med allergy is, and when they tell me heart racing with epi, I explain that it's a side effect and supposed to do that, then explain that it's basically adrenaline and give an example of a car pulling right out in front of them and the body goes "AHHHH!" only times 1000. I had one pt tell me that she still refuses to have it because she can't take the tachycardia. I've done allergy testing for -caine allergies and have had pts react to lidocaine but not carbocaine, or vice versa, so I know there are true allergies to the caine family and not so much to the epi. It just cracks me up when their dentist is telling them not to ever have epi again because they're allergic to it, yet it's more likely the lidocaine causing all that. I've also heard the allergy to benadryl due to drowsiness, allergy to morphine because it causes itching, and allergy to lisinopril because it causes a cough. I'm also seeing a TON of gluten allergies (self-diagnosed, of course) because that's the new thing in Hollywood. When we test for wheat and gluten allergies and it comes back negative, suddenly we're the idiots, even when we explain the difference between an allergy and intolerance. Some people. . .