{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:59:05Z","timestamp":1785128345023,"version":"3.55.0"},"reference-count":86,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Naunyn-Schmiedeberg's Arch Pharmacol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Anaphylaxis can be life-threatening\u2014due to its rapid-progressing and often unpredictable nature. Especially in such medical emergencies, robust clinical trials regarding adjunctive therapies can be scarce and recommendations across literature may vary. Hence, the aim of this study is to investigate the evolution of recommendations for the pharmacological management of anaphylaxis in established pharmacology textbooks over time. The following German textbook series were included:\n                    <jats:italic>Aktories<\/jats:italic>\n                    ,\n                    <jats:italic>L\u00fcllmann<\/jats:italic>\n                    , and\n                    <jats:italic>Karow<\/jats:italic>\n                    . The US standard work\n                    <jats:italic>Goodman &amp; Gilman<\/jats:italic>\n                    was reviewed for an international comparison. This study focuses on epinephrine, H\n                    <jats:sub>1<\/jats:sub>\n                    R-antagonists, H\n                    <jats:sub>2<\/jats:sub>\n                    R-antagonists, and GCR-agonists\u2014analyzing their potential use in anaphylaxis via predefined criteria and contextualizing it using the current AWMF anaphylaxis guideline. Epinephrine is continuously recommended as first-line treatment in anaphylaxis across textbooks and decades\u2014with a shift towards i.m. use. Differences prevail regarding the anaphylaxis grade at which epinephrine is indicated vs. when H\n                    <jats:sub>1<\/jats:sub>\n                    R-antagonists are considered sufficient. Overall, H\n                    <jats:sub>1<\/jats:sub>\n                    R-antagonists are noted as adjuncts in at least more severe anaphylaxis. H\n                    <jats:sub>2<\/jats:sub>\n                    R-antagonists appear to lack clinical relevance and are inconsistently discussed as adjunctive add-ons. While GCR-agonists are consistently recommended as adjuncts in anaphylaxis, the included US literature deviates from the German consensus of a high-dose approach. Moreover, there are differences regarding fluid resuscitation\u2014some textbooks merely predate the guideline\u2019s recommendation to refrain from colloids, whereas others remain at odds with it even in their latest editions. While there is general agreement on epinephrine\u2019s central role in anaphylaxis management, recommendations in literature regarding the specific roles of certain adjunctive measures vary\u2014likely reflecting the limited evidence.\n                  <\/jats:p>","DOI":"10.1007\/s00210-026-05734-7","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:21:23Z","timestamp":1785118883000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The evolution of pharmacological recommendations for anaphylaxis: a comparative analysis of established textbooks"],"prefix":"10.1007","author":[{"given":"Annika Stina","family":"McGuigan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"5734_CR1","volume-title":"Allgemeine und spezielle Pharmakologie und Toxikologie","author":"K Aktories","year":"2005","unstructured":"Aktories K, F\u00f6rstermann U, Hofmann F, Starke K (2005) Allgemeine und spezielle Pharmakologie und Toxikologie, 9th edn. 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