Anaphylaxis


Anaphylaxis (an-a-fi-LAK-sis) is a serious, life-threatening allergic reaction. The most common anaphylactic reactions are to foods, insect stings, medications and latex.

Some people are at a higher risk of developing anaphylaxis. If you have allergies or asthma along with a family history of anaphylaxis then you are more likely to suffer from anaphylaxis. If you have experienced anaphylaxis your risk of having another anaphylactic reaction increases.

Early detection, accurate diagnosis and successful management of allergies are of absolute necessity to help avoid this type of life threatening reaction. Our allergists have specialized training and experience to diagnose the problem and help you develop a plan to guard against such life threatening reactions.

SYMPTOMS

If you are allergic to a substance, your immune system overreacts to this allergen by releasing chemicals that cause allergy symptoms. Typically, these bothersome symptoms occur in one location of the body. However, some people are susceptible to a much more serious anaphylactic reaction.This reaction typically affects more than one part of the body at the same time.

  • Mild symptoms may include one or more of the following:
  • Hives (reddish, swollen, itchy areas on the skin)
  • Eczema (a persistent dry, itchy rash)
  • Redness of the skin or around the eyes
  • Itchy mouth or ear canal
  • Nausea or vomiting
  • Diarrhea
  • Stomach pain
  • Nasal congestion or a runny nose
  • Sneezing Slight, dry cough
  • Odd taste in mouth
  • Uterine contractions

 Severe symptoms may include one or more of the following:

  • Obstructive swelling of the lips, tongue, and/or throat
  • Trouble swallowing
  • Shortness of breath or wheezing
  • Turning blue
  • Drop in blood pressure (feeling faint, confused, weak, passing out)
  • Loss of consciousness
  • Chest pain
  • A weak or “thread” pulse
  • Sense of “impending doom”

Severe symptoms, alone or in combination with milder symptoms, may be signs of anaphylaxis and require immediate treatment.

TREATMENTS

Anaphylaxis requires immediate medical treatment, including an injection of epinephrine and a trip to a hospital emergency room. If it isn’t treated properly, anaphylaxis can be fatal.
Currently, the only way to prevent a food-allergic reaction is to avoid the problem food.

Once you have been diagnosed with an allergy, talk to your doctor about how allergic reactions should be treated. Have your doctor create a written Anaphylaxis Emergency Care Plan so that you and others will know what to do in the event of a reaction.

Mild to moderate symptoms (e.g., itching, sneezing, hives and rashes) are often treated with antihistamines and oral or topical steroids.

For patients at risk of experiencing a severe reaction (anaphylaxis), epinephrine is prescribed. Epinephrine is the only medication that can reverse the symptoms of anaphylaxis. It is available in an auto-injector (Auvi-Q™, EpiPen® or Adrenaclick®). If prescribed, use epinephrine at the first sign of an allergic reaction and call 911. Request an ambulance and tell the dispatchers that you have just used epinephrine for a suspected food-induced anaphylactic reaction. Patients should always go to the emergency room for further treatment, even if symptoms appear to resolve after epinephrine is administered.

Epinephrine is a safe drug, with the risks of anaphylaxis outweighing any risks of administering the medication. Extra caution is only needed for elderly patients or those with known heart disease where an increased heart rate could be problematic. Nonetheless, epinephrine should be used to treat anaphylaxis in these individuals. Patients should proceed to the emergency room after epinephrine is administered in case additional medication or treatment is needed to manage the reaction, not because epinephrine is a dangerous drug.

Once epinephrine is administered, other medications also may be used to control the reaction:
Steroids (e.g., cortisone) may be given, typically in the emergency room, to help reduce inflammation after an anaphylactic attack. Although steroids do not work fast enough for emergency treatment, they may help prevent a recurrence after the initial reaction has been treated.

Antihistamines, known as H1 blockers, are prescribed to relieve mild allergy symptoms, although they cannot control a severe reaction. Medications in this class include diphendydramine (Benadryl®) and cetirizine (Zyrtec®). An antihistamine should never be given as a substitute for epinephrine.

Asthma Medications. Short-acting bronchodilators (known as “rescue” inhalers), such as albuterol (Alupent®, Proventil®, Ventolin®), may be used to help relieve breathing problems once epinephrine has been given, particularly if you are experiencing asthma symptoms. They should not be depended upon to treat the breathing problems that can occur during anaphylaxis—use the epinephrine.

 

An effective treatment plan includes all of the following:

Strict avoidance of problem allergens
Working with your doctor to develop an Anaphylaxis Emergency Care Plan Wearing emergency medical identification (e.g., bracelet, other jewelry) Carrying your epinephrine medication wherever you go Taking your medication at the first sign of a reaction Getting to an emergency room for follow-up treatment if you have a severe reaction?

Again, early detection, accurate diagnosis and successful management of allergies are of absolute necessity. Our allergists have specialized training and experience to diagnose the problem and help you develop a plan to guard against such reactions in the future.