Anaphylaxis

Anaphylaxis
  • Evaluation
    • Description—acute, potentially life-threatening hypersensitivity reaction with systemic effects
    • Clinical:
      • Cardiovascular—lightheaded and syncope secondary to hypotension
      • Respiratory—rhinitis, sneezing → stridor, chest tightness, shortness of breath, wheeze, respiratory arrest
      • Skin—pruritus, flushing, hives, angioedema
      • Neurologic—anxiety
      • Gastrointestinal (GI)—nausea, vomiting, diarrhea, cramping
    • Mechanism—antigen/antibody-mediated response involving immunoglobulin E (IgE)
    • Epidemiology
      • A total of 500 to 1,000 deaths occur annually in the United States.
      • More than 500,000 serious allergic reactions to medications occur annually in hospitals.
    • Risk factors
      • Age—children have more food-related anaphylaxis; adults more so with antibiotics, stings.
        • Common foods—peanuts, nuts, fish, shellfish, milk, eggs, sesame
        • Common drugs—penicillin, sulfa, nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, contrast, and so on
      • Sex—men have a higher occurrence with stings; women with latex, Aspirin, contrast.
      • Exposure—the more time since last exposure, the less likely a reaction will transpire.
      • Location—occurrence is higher in rural patients than in urban.
  • Management
    • Stop the agent causing the insult.
    • Assess airway, breathing, circulation (ABCs).
    • Treat!
  • Pharmacologic treatment
Tags:
Aug 28, 2016 | Posted by in PSYCHIATRY | Comments Off on Anaphylaxis

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