Life-Threatening Anaphylaxis Following Intravenous Ondansetron in a Previously Healthy Woman: A Case Report
Abstract
Ondansetron is a drug that is prescribed to treat and prevent nausea and vomiting induced by chemotherapy, radiation therapy, surgical procedures, analgesics, or migraine. It is also commonly used in clinical practice for the symptomatic management of nausea and vomiting due to acute gastroenteritis. The drug is generally acknowledged for its safety, apart from common side effects such as constipation, hot flushes, and headaches. Some rare adverse events, including arrhythmias and QT interval prolongation, have been reported in isolated cases in the literature. However, severe anaphylactic reactions are rarely reported but hold significant value. We describe a rare case of potentially fatal anaphylaxis to a commonly used and generally considered safe medicine. The patient, a 56-year-old female with no known comorbidities, arrived at the Emergency Room complaining of nausea and recurrent vomiting, possibly due to the ingestion of unhygienic, undercooked food. She was hemodynamically stable, with signs of dehydration present. Intravenous ondansetron 4 mg and intravenous fluids (Ringer's Lactate) were administered. Consequently, she developed a sudden severe anaphylactic shock leading to hypotension, tachycardia, and bronchospasm, leading to respiratory distress, managed with endotracheal intubation, vasopressor support, intramuscular adrenaline, and urgent ICU admission. After six hours of intensive treatment, she survived and was extubated uneventfully. Further blood and skin…
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