During a paclitaxel infusion, the patient develops throat clearing and shortness of breath. What is the first immediate action?

• A. Stop the paclitaxel infusion
• B. Continue the infusion and reassess in 5 minutes
• C. Administer a second dose of corticosteroids
• D. Call the physician but maintain the infusion

Answer: (A)

When a patient experiences throat clearing and shortness of breath during a paclitaxel infusion, it signals a possible hypersensitivity reaction to the drug. The immediate action is to stop the infusion to halt further exposure and prevent progression of the reaction. Once the infusion is stopped, quickly assess the patient’s airway, breathing, and circulation and follow the facility’s emergency protocol: call for help, provide oxygen if needed, and prepare to treat a potential anaphylactic reaction with appropriate medications and supportive care. Continuing the infusion or delaying action would allow the reaction to worsen, and giving corticosteroids right away is not the first step because they do not act quickly enough in an acute reaction.