The American journal of emergency medicine
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We report a case of atorvastatin-induced hypersensitivity reaction in a 58-year-old male following first exposure to the drug. The patient took one dose of atorvastatin 40 mg and presented to the emergency department (ED) within 24 h with a chief complaint of throat swelling, trouble swallowing, and throat pain. The patient did not have pruritis or skin manifestations. ⋯ Statin-induced hypersensitivity reactions could be explained by statins' effects on bradykinin 2 receptors that potentiate vasodilation and leading to angioedema. In the literature, cases of hypersensitivity associated with atorvastatin present after months of cumulative exposure. Therefore, this case is unique in that a reaction developed within 24 h of that first dose.
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Administration of 3% sodiumchloride through a peripheral venous catheter is associated with risk of infusion-related adverse events (IRAE) due to its high osmolarity. Given this concern and the paucity of data regarding these events,many hospitals have policies that require central line administration of 3% sodiumchloride. ⋯ These data suggest that IRAE occurred more frequently when 3% sodium chloride was administered over a longer duration and themajority of events weremild with no permanent tissue injury. Itmay be reasonable to consider peripheral administration of 3% sodium chloride in the acute care setting for a short duration, although additional studies are needed to continue to evaluate its safety.