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Hi,
I am currently in UK. Me and my wife are blessed with a baby girl on 24th April 2012. My wife was earlier in UK during first and second trimester of her pregnancy and she was registered in Hammersmith hospital London. But due my job she went back to India for delivery.

In the last days of delivery her blood pressure increased very much so doctors in India advice to get baby delivered early by 15 days. They also gave her blood pressure control medicine during her pregnancy. Her delivery was suppose to happen at 8th May but doctor due to her increased blood pressure asked her to admit on 23rd April. They then induced the delivery. They applied some gel sort of thing for inducing the labour pains. Baby was then delivered as normal in morning @8:24 AM on 24th April. Everything was ok till then. Doctor prescribed her normal antibiotic after pregnancy. And everything was normal.

Suddenly at 8:15 PM in the evening my wife started scratching her skin. She said to me the it is very itchy. Then suddenly her face started to swell. So I felt something wrong and started calling for doctor but nurse assumed to be normal assigned basic allergy tablet but in 2 mins it went drastic. then I shouted and doctor came in.
It was our good luck that doctor husband was lungs specialist and he has all relevant instrument.. She gave her few injection, put oxygen supply and keep slapping her and beating so that she remain conscious. All of sudden my wife heart beat were gone. She was almost dead then doctor beat her heart and somehow brought my wife back. After around after 1 hour everything was normal.

According to doctor it was a electrifying attack of wind pipe getting choked, Some medicine has made drastic reaction. She was not able to exactly comment what was the reason and as I was in a severe shock after that so didn’t inquired much. Please can you help what could be the possible reason. I carried out allergy test in India and there was no satisfactory answer. Now my wife is in UK with our baby.

For Info (the medicines she was given at that time were):
1) A Tablet which contained Amoxicillin and Clavulanic Acid (As antibiotic)
2) A Tablet Combiflame which contained ibuprofen + paracetamol(As Painkiller)
3) A Tablet Methergine
4) A Tablet which contained amlodipine(To control bloodpressure/ Hypertension)

Can anyone of this or this combination could lead to this severe reaction? Severe respiratory attack?

I am so afraid for giving her medicine that last week she had a tooth extraction and they prescribed antibiotic but I didn’t let her take them. So please doctors can you can help me where I can get allergy tested and somehow at least identify the actual cause or medicine. So that in future I can be precaution against that.

Thanks a lot in advance for the response.

Hello

Having read your post I agree your wife needs drug allergy testing. Any of the drugs you mentioned can cause anaphylactic reactions, however statistically antibiotic (Co-amoxiclav) and Ibuprofen/Paracetamol are the most likely culprits. It would be helpful to know the exact timings of the medications, in relation to her reaction. Would you be able to obtain this information from India?.
Please check BSACI website for clinics nearest to you. Go into “Professionals”, then “Find a clinic”. In your search put “Adult” in - Age group - and in -Service Type - put “Drug Allergy with Challenge”.
For now, your wife should avoid all penicillin containing antibiotics, as well as non steroidal anti-inflammatory durgs including ibuprofen and paracetamol . She is less likely to need methergine or amlodipine, however these should be also avoided until further testing.
Best of luck, Joanna

Hello Dr. Joanna,

Many thanks for your reply. She was given these medicines twice a day. First dose, she took at about 11 AM in the morning and then she was given second dose at about 8 PM in the evening. Then she took her dinner at about 9 PM, then at about 9.45 PM suddenly she started some itching all over her body and within some seconds her breathing got choked and she was unable to breathe.
She was given injections of hydrocortisone, adrenaline, avil. She had got cardio pulmonary resucitation attack.

Hi
So if I understand correctly your wife was given all of the medications by mouth and all at the same time?
And then there was a long gap of 1hour 45min. She also ate her dinner at 1 hr point.
This story is slightly more complex than I thought.
Allergic reactions to medication usually occur rapidly following their ingestion (most commonly within 30min to 1 hour), but it is possible to react up to 2 hours after.
Food at 1 hour is a complicating factor, firstly food slows absorption of the medications and secondly food can also trigger allergic reaction.
Your wife needs to be reviewed in Drug Allergy Clinic where we would start by testing her with the drugs she received, but we would also look at (possibly test her with) the food she consumed just before her anaphylaxis. Until then she should avoid all the meds I have mentioned before.
Best wishes,
Joanna

Hi Joanna,

Yes, you are right. Every doctor who was present there in India at that time was shocked as first of all everyone was saying same that medicines taken orally does not normally do that severe reaction.And another thing was nothing happened when she took her first dose ie the morning dose. When she took her second dose in the evening, all that happened and yes after about two hours.

I agree with you and even I wanted to get her reviewed in drug allergy clinic so that we can be sure and precautious about her medications.