Anaphylaxis Flashcards
What are the main cells involved in anaphylaxis?
Mast cells and basophils
Derm symptoms of anaphylaxis?
Urticaria (may be absent in up to 10%)
Respiratory symtoms of anaphylaxis?
- Angioedema (may involve larynx)
- Bronchospasm/wheezing
- Rhinorrhea/cough
Cardiovascular symptoms of anaphylaxis?
- Cardiovascular collapse
GI symptoms of angioedema?
Abdominal pain, N/V/D
What is an anaphactoid reaction?
- It is the direct release of histamine (as opposed to IgE mediated)
- No prior exposure necessary
- Examples radiographic contrast
What patients with anaphylaxis need epinephrine?
Those with life threatening symptoms. Not all patients need.
Those with airway symptoms need an IM dose immediately
Dose of epinephrine for severe cases?
0.1 mg IV over 5-10 min 1:100,000 dilution
Dose of epinephrine for less severe cases?
0.3-0.5 mg IM of 1:1,000 every 5-10 min anterior thigh
Besides epinephrine, what other drugs are indicated for anaphylaxis?
- H1 and H2 blockers
- Crystalloids for hypotension
- Albuterol/Ipratroprium (for bronchospasm)
- Steroids (not supported by literature but still given often)
What is the dispo plan in an anaphylactic patient that you have controlled their symptoms?
Watch them for 4 hours and send them how with an epi-pen
What is the only difference between an anaphylactic (IgE) reaction and anaphylactoid (direct-release) reaction?
No prior sensitization required for anaphylactoid
What are symptoms of early anaphylaxis?
Increased secretions
- Watery eyes
- Rhinorrhea
- Bronchial secretions
- Bronchial constriction (wheezing)
What are late stages of anaphylaxis?
Increased capillary permeability
- CV compromise
- Hypotension
- Urticaria
- Angioedema
What are the most common medications to cause anaphylaxis?
- PCN
- Sulfa drugs
- IV contrast
Nearly all deaths caused by anaphylaxis are caused by what?
Airway compromise (so get control early)
In general, all ampules of IV epi have how much drug?
1 mg
How long should steroids be given after anaphylaxis?
For days
What might you need to give an anaphylactic patient that’s on β-blockers?
Glucagon so epi can work
In an anaphylactic that’s wheezing, what should you try?
Inhaled β agonist and racemic epi
