ACE and anaphylaxis: Extremes of age, underlying cardiovascular or respiratory disease, and concurrent beta blocker (BB), angiotensin-converting enzyme inhibitor (ACE-I), or non-steroidal anti-inflammatory drug use have been identified as potential risk factors for severe or refractory anaphylactic reactions; however, there is conflicting evidence regarding the influence of BB and ACE-I use on the severity of anaphylaxis and the need for repeat epinephrine administration in this setting [2].