Anaphylaxis Flashcards
How is it similar to sepsis?
Mediator release
How is it difference than sepsis?
Antigen exposure –> mediator release
Initial S/S
Hives (from capital permeability from the skin)
Flushing (vasodilation)
Tachycardia
Vasodilation causes
Hypotension
Mucosal edema/airway (most vasodilation is in upper airway)
Obstruction
Capillary permeability causes
Hypovolemia
Pulmonary Congestion
3 Drugs of choice
Bronchodilator (Inhaled Beta - 2 agonists)
Corticosteroids (suppresses inflammatory - prevent delayed reaction)
Antihistamine
H1 Blocker
Benadryl
H2 Blocker
Cimetindine, Ranitdaine, Famotidine
Mild anaphylaxis characterized by
Normal BP
Minimal RD
Mild anaphylaxis dosage of EPI
IM 1:1,000
Severe Anaphylaxis characterized by
Hypotension
Severe RD
Severe anaphylaxis dosage of EPI
IV 1:10,000
Repeat 15-30 mins PRN up to 2 doses
What can BB inhibit?
The work of EPI in anaphylaxis
What can a BB do to the lungs?
Vasoconstriction
Bronchospams
EPI has both..
Alpha-Adrenergic (Vasoconstriciton)
Beta-Adrenergic (Vasodilation)
What happens if you give both EPI and a nonselective BB?
Non selective BB prevents the vasodilation
Leaving unopposed Alpha vasoconstriction
What can be given for pt’s on BB that don’t respond to EPI
glucagon
IM EPI dosage calculation if you have time..
0.01 mg/kg no greater than 5mg for single dose
Epi Infants <10kg autoinjector
0.1mg or 0.15mg (- if 0.1mg is not avaliable)
Epi 10-25kg
0.15 mg
Epi 25-50kg
0.3mg
> 50kg
0.5mg
When can epi be repeated
5-15min intervals
Epi IV infusion starting rate
0.1 mcg/kg/minute increase by 0.05 mcg/kg/minute every 2-3 mins to improve perfusion
