ANAPHYLAXIS

 Anaphylaxis is a serious allergic reaction that

has a rapid onset and can cause death
 Allergic reaction – is the manifestation of tissue
injury resulting from reaction between antigen
and antibody
 Antigen –protein that the body recognizes as
foreign
 Antibodies – protein substances that protect
against invaders (IgE, IgD, IgG, IgM, IgA)
ANAPHYLAXIS

 Allergen triggers B cells to make IgE antibodies

 IgE antibodies will attach to MAST cells or

basophils
 When the allergen reappears, it binds to igE and
triggers the mast cells to release its chemicals
 such as histamine, prostaglandin, leukotrienes,
etc which produces the symptoms
 EXAMPLES OF CHEMICAL MEDIATORS
 Histamine – vasodilation, contraction of bronchial
smooth muscles
 Prostaglandins – smooth muscle contraction,
vasodilation, increased capillary permeability
 Leukotrienes – inflammatory response,
bronchospasm
 Bradykinin – contracts smooth muscles of bronchi
and blood vessels, increase capillary permeability
causing edema, stimulates nerve fiber to produce
pain
 SIGNS AND SYMPTOMS OF ANAPHYLAXIS

 The first signs of an anaphylactic reaction

may look like typical allergy symptoms:
a runny nose or a skin rash.
• Coughing, wheezing, pain, or tightness in
your chest
• Fainting, dizziness, confusion, or weakness
• Hives/rash, itchy, swollen, or red skin
SIGNS AND SYMPTOMS OF ANAPHYLAXIS

• Swollen or itchy lips or tongue

• Swollen or itchy throat, hoarse voice, trouble
swallowing, tightness in your throat
• Vomiting, diarrhea, or cramps
• Weak pulse, paleness
CAUSES OF ANAPHYLAXIS

 Typical food triggers for children are:

• Peanuts, Shellfish, Fish, Milk
• Eggs, Soy, Wheat

 Common food triggers for adults are:

• Shellfish
• Tree nuts (walnuts, hazel nuts, cashews,
pistachios, and almonds)
• Peanuts
• Food preservatives
CAUSES OF ANAPHYLAXIS

❑ medication such as Penicillin

❑ aspirin, ibuprofen, naproxen, diclofenac,
and other NSAIDs (nonsteroidal anti-
inflammatory drugs ),
❑ anti-seizure medications (phenobarbital,
phenytoin, carbamazepine)
CAUSES OF ANAPHYLAXIS

• Pollens, grass
• Stings or bites from bees, wasps, yellow
jackets, hornets, and fire ants
• Latex, found in hospital gloves, balloons,
and rubber bands
 Some people can have an anaphylactic
reaction if they breathe in latex
EMERGENCY TREATMENT

 Epinephrine injection to treat life-

threatening allergic reactions
 Epinephrine is in a class of medications
called alpha- and beta-adrenergic
agonists (sympathomimetic agents).
 It works by relaxing the muscles in the
airways and tightening the blood vessels.
EMERGENCY TREATMENT

 Epinephrine is the most effective

treatment for anaphylaxis, and the shot
should be given right away (usually in
the thigh).
 If with history of previous anaphylactic
reaction, at least two doses of
epinephrine should be carried by the
patient at all times.
 It expires after about a year, so
prescription should be up to date.
EMERGENCY TREATMENT

 Either in the ambulance or at the hospital,

fluids and medications are given
antihistamines and steroids to help the
patient breathe

 If the patient is unable to breathe, the

medical personnel might do a kind of
surgery called a tracheostomy that puts
the tube directly into the windpipe.
MEDICAL MANAGEMENT

 Management depends on the severity of reaction

 Cardiac arrest – CPR

 Oxygen during resuscitation

 Epinephrine

 Antihistamine

 Corticosteroids

 Volume expanders such as IV infusion of NSS, LRs,

albumin to maintain BP
 vasopressors like norepinephrine, dobutamine, dopamine
to constrict blood vessel and increase BP
NOTES
 In rare cases, it can be triggered by 2 to 4 hours of exercise after eating certain foods
or by exercise on its own.
 Anaphylactic reactions usually start within minutes of contact with the trigger, but
they can also happen an hour or more later.
 Some people never figure out what caused their reactions. That’s known as
idiopathic anaphylaxis.
 If you don’t know your triggers, you can’t avoid them. So it’s especially important to
carry epinephrine injectors, make sure you and people close to you know how to use
them, and wear medical alert jewelry.