{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:38:34Z","timestamp":1761975514676,"version":"3.40.4"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,10,8]]},"abstract":"<jats:p>A 42-year-old woman with end-stage renal failure was admitted to the intensive care unit following resuscitation from a pulseless electrical activity cardiac arrest after intravenous piperacillin\/tazobactam. Persistent bradycardia and hypotension, unresponsive to epinephrine and norepinephrine, were suspected to have been exacerbated by chronic labetalol therapy for resistant arterial hypertension. As an alternative, the non-adrenergic inotrope, enoximone, was started. This, combined with thrombolysis for possible pulmonary embolism, heralded significant haemodynamic improvement, allowing weaning from inotropic support. A clear CT pulmonary angiogram 2\u2005days post-arrest and significantly raised mast cell tryptase levels confirmed anaphylaxis rather than pulmonary embolism as the precipitating cause. We believe this to be the first case report of phosphodiesterase-III inhibitor use in the management of anaphylaxis complicated by \u03b1\/\u03b2-blockade, and discuss the mechanism behind this effect and comparison with the more commonly reported use of glucagon.<\/jats:p>","DOI":"10.1136\/bcr-2015-212432","type":"journal-article","created":{"date-parts":[[2015,10,26]],"date-time":"2015-10-26T13:57:51Z","timestamp":1445867871000},"page":"bcr2015212432","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Use of enoximone in management of anaphylaxis complicated by labetalol use"],"prefix":"10.1136","volume":"2015","author":[{"given":"Sophie","family":"Hayhoe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vilas","family":"Navapurkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Conway Morris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,10,26]]},"reference":[{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f602"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2010.10.015"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.284427"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.4","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.170308"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.5","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e32833eafa3"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.08.016"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.10.021"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2014.10.007"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.9","first-page":"H511","article-title":"Role of cAMP-dependent protein kinase in cAMP-mediated vasodilation","volume":"262","author":"Haynes","year":"1992","journal-title":"Am J Physiol"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.10","doi-asserted-by":"publisher","DOI":"10.1159\/000234915"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.11","first-page":"1229","article-title":"Hypersensitivity reactions of the heart: reduction of anaphylactic crisis by theophylline or glucagon","volume":"47","author":"Levi","year":"1971","journal-title":"Bull N Y Acad Med"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.12","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181770b42"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.13","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.582471"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2006.05.010"},{"key":"2025042707300049000_2015.oct26_1.bcr2015212432.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052367"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-212432","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T14:30:09Z","timestamp":1745764209000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-212432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,26]]},"references-count":15,"alternative-id":["10.1136\/bcr-2015-212432"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-212432","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2015,10,26]]}}}