Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at NSU
Clinical features of anaphylaxis: S ECG
Skin, 90%
Expiratory wheezing and other respiratory symptoms, 70%
Cardiovascular, 40%
GI and oral, 24%
Common causes of anaphylaxis: FIDL
Foods
Insect stings - bee and wasp
Drugs
Latex rubber
Drugs causing anaphylaxis: AAA CAN
Antibiotics (especially penicillin)
Anesthetic drugs IV
ASA
Contrast media IV
Analgesic opioids
NSAIDs
Risk factors for anaphylaxis due to immunotherapy include: OH BEA
Observation - insufficient, following injection
High allergen dose
Beta-blockers
Errors in administration
Asthma, poorly controlled
Drugs for acute management of anaphylaxis: EASI
Epinephrine IM
Antihistamines PO, IM
Steroids PO, IM, IV
Inhaled b2-agonists, if wheezing. IV fluids if hypotension.
Mnemonic for EpiPen dose
30 kg or more
0.3 mg dose of epinephrine (EpiPen)
Epinephrine Auto-Injectors
Dey Pharma is no longer shipping SINGLE EpiPen Auto-Injectors - only 2-PAKs will be available:
2
2-PAK EpiPen
20% of patients need
2nd dose in anaphylaxis
Epinephrine Auto-Injectors
Dey Pharma is no longer shipping SINGLE EpiPen Auto-Injectors - only 2-PAKs will be available:
2
2-PAK EpiPen
20% of patients need
2nd dose in anaphylaxis
Epinephrine (adrenaline) is the first-line the treatment of anaphylaxis. Adult intramuscular dose is 0.3 to 0.5 ml of 1:1,000 concentration. This should be given in the lateral aspect of the thigh by intramuscular injection. The dose can be repeated every 5 to 15 minutes, depending upon the response, for 3-4 doses. The same is true for children except the dose is 0.01 mg per kg (AAAAI Ask the Expert, 2012).
References
Anaphylaxis guidelines by World Allergy Organization. JACI, 2011.
Updated: 05/26/2012
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