anaphylaxis take 3

Today we discussed a case of a women who had an anaphylactic reaction post gold infusion.

Typically we think of the following drugs in association with anaphylaxis (although a lot of drugs can cause rare reactions)

- Antibiotics (75% of all fatal anaphylactic reactions are due to penicillin)

• Non-steroidal anti-inflammatory agents (including aspirin)

• Anesthetics

• Latex

• Iodine (contrast)

Our previous talks on anaphylaxis can be viewed HERE and HERE, review articles and doses can be found on those pages. 

On D/C a good plan would consider the following:

• Ensure that the patient understands she has a serious allergy, and Document it in the medical chart

• EpiPen Rx and instructions for use 
• MedicAlert bracelet 
• Written action plan if anaphylaxis recurs outside the hospital setting6 
• Notification of any outside providers 
• Consideration of referral to an allergist 

anaphylaxis

Today's Morning report was on Anaphylaxis.

We covered the vague presenting symptoms such as abdominal pain and sweating, in addition to the expected signs of urticaria, macular papular rash, andgioedema and bronchospasm.

Important immediate management consists of:

Airway (?intubate)

EPI - Be careful! the doses are tricky! 0.5mg EPI-->careful the suspension.

IV access and fluids (there is impending cardiovascular compromise)

O2

Use your resources and dont waste time with steroids and anti histamines acutely

An article about lessons from failed treatment can be found here. 

A review article about anaphylaxis can be found here. 

Happy last day of block 2.