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Reload this Page Sulfa allergic patient brought to the ER with anaphylactic reaction
Clinical Vignette A clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.

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Sulfa allergic patient brought to the ER with anaphylactic reaction - 24-08-2006, 10:21 AM
A 57 yr old man is brought by ambulance to the emergency department after experiencing an anaphylactic reaction. The patient's wife stated that the patient ingested a medication to treat his chronic arthritis pain about 30 minutes prior to the onset of symptoms. The patient has a past medical history significant for "sulfa" allergy. Which of the following medications did he most likely ingest?
A. Acetaminophen
B. Aspirin
C. Celecoxib
D. Ketorolac
E. Tramadol

I Love Clinical Vignette a concise presentation of an interesting & challenging patient encounter that stimulates an inquisitive learning session.
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Re: Sulfa allergic patient brought to the ER with anaphylactic reaction - 24-08-2006, 10:52 AM
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Originally Posted by Oak View Post
A 57 yr old man is brought by ambulance to the emergency department after experiencing an anaphylactic reaction. The patient's wife stated that the patient ingested a medication to treat his chronic arthritis pain about 30 minutes prior to the onset of symptoms. The patient has a past medical history significant for "sulfa" allergy. Which of the following medications did he most likely ingest?
A. Acetaminophen
B. Aspirin
C. Celecoxib
D. Ketorolac
E. Tramadol
well i think it's cox-2 inhibitor so answer must be C. Celecoxib rather then aspirin
waiting for your response
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Re: Sulfa allergic patient brought to the ER with anaphylactic reaction - 25-08-2006, 05:15 AM
I'd go for celecoxib.It has a sulphonamide-like structure unlike the rest of the drugs.
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Re: Sulfa allergic patient brought to the ER with anaphylactic reaction - 25-08-2006, 10:01 AM
I agree with Bharat and Kenneth masamaro.I go with celecoxib-a sulfa group
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The correct answer is C - 25-08-2006, 06:15 PM
Yes, the correct answer is C. The patient has a past medical history significant for "sulfa" allergies; therefore, he should not be prescribed any medications that contain sulfur or chemically related compounds. Examples of these products include celecoxib, sulfonylureas, sulfamethoxazole, sulfasalazine, and thiazide diuretics. Celecoxib is a cyclooxygenase-2 (COX-2) inhibitor indicated for the treatment of mild-moderate pain and inflammation. Since this medication contains a "sulfa" component, it should not be administered to patients with sulfa allergies. All of the other answer choices can be safely administered to this patient.

Acetaminophen (choice A) possesses analgesic and antipyretic effects, with no anti-inflammatory properties.

Aspirin (choice B) is a salicylate with analgesic, antipyretic, and anti-inflammatory properties.

Ketorolac (choice D) is nonsteroidal anti-inflammatory drug (NSAID) with analgesic, antipyretic, and anti-inflammatory properties.

Tramadol (choice E) is a centrally acting synthetic analgesic compound that has action at the mu opiate receptor and may inhibit the uptake of serotonin and norepinephrine. This agent produces analgesia with little respiratory depression. It is indicated for treatment of moderate to severe pain.

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