Editing Anaphylaxis (section)

===Medication===
Any medication may potentially trigger anaphylaxis. The most common are [[β-lactam antibiotic]]s (such as [[penicillin]]) followed by [[aspirin]] and [[Non-steroidal anti-inflammatory drug|NSAIDs]].<ref name=Review09/><ref name=WHO2015>{{cite journal|vauthors = Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK, Lockey RF, El-Gamal YM, Brown SG, Park HS, Sheikh A |title=2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines.|journal=The World Allergy Organization Journal|date=2015|volume=8|issue=1|pages=32|pmid=26525001|pmc=4625730|doi=10.1186/s40413-015-0080-1 |doi-access=free }}</ref> Other [[Antibacterial|antibiotics]] are implicated less frequently.<ref name=WHO2015/> Anaphylactic reactions to NSAIDs are either agent specific or occur among those that are structurally similar meaning that those who are allergic to one NSAID can typically tolerate a different one or different group of NSAIDs.<ref>{{cite journal|last1=Modena|first1=B|last2=White|first2=AA|last3=Woessner|first3=KM|title=Aspirin and Nonsteroidal Antiinflammatory Drugs Hypersensitivity and Management.|journal=Immunology and Allergy Clinics of North America|date=November 2017|volume=37|issue=4|pages=727–749|doi=10.1016/j.iac.2017.07.008|pmid=28965637}}</ref> Other relatively common causes include [[chemotherapy]], [[vaccine]]s, [[protamine]] and [[Herbalism|herbal]] preparations.<ref name=World11/> Some medications ([[vancomycin]], [[morphine]], [[Radiocontrast agent|x-ray contrast]] among others) cause anaphylaxis by directly triggering mast cell [[degranulation]].<ref name=CEA11/>

The frequency of a reaction to an agent partly depends on the frequency of its use and partly on its intrinsic properties.<ref name=Drug01>{{cite journal|last=Drain|first=KL|author2=Volcheck, GW|title=Preventing and managing drug-induced anaphylaxis|journal=Drug Safety |year=2001|volume=24|issue=11|pages=843–53|pmid=11665871|doi=10.2165/00002018-200124110-00005|s2cid=24840296}}</ref> Anaphylaxis to penicillin or [[cephalosporin]]s occurs only after it binds to proteins inside the body with some agents binding more easily than others.<ref name=Rosen2010/> Anaphylaxis to penicillin occurs once in every 2,000 to 10,000 courses of treatment, with death occurring in fewer than one in every 50,000 courses of treatment.<ref name=Rosen2010/> Anaphylaxis to aspirin and NSAIDs occurs in about one in every 50,000 persons.<ref name=Rosen2010/> If someone has a reaction to penicillin, his or her risk of a reaction to cephalosporins is greater but still less than one in 1,000.<ref name=Rosen2010/> The old radiocontrast agents caused reactions in 1% of cases, while the newer lower osmolar agents cause reactions in 0.04% of cases.<ref name=Drug01/>