| Avoidance and education are the mainstays of | | | | attention.1 Since there is no way to predict the |
| prevention therapy for those who suffer from | | | | severity of a reaction, and because anaphylaxis can |
| severe allergies. However, the allergen cannot always | | | | progress so rapidly, waiting for the paramedics or ER |
| be avoided, so it is important to know what | | | | staff to administer epinephrine may greatly increase |
| emergency measures to take (i.e., epinephrine | | | | the risk of death. Therefore, it is essential that |
| self-injection) when exposure occurs. It is also | | | | anyone with a history of anaphylaxis keep |
| important to be on guard for the recurrence of an | | | | epinephrine auto-injectors, such as EpiPen® |
| allergic reaction in the hours after the main reaction | | | | auto-injectors, on hand at all times and be prepared |
| has occurred, also known as a biphasic reaction. | | | | to use these whenever a reaction occurs. |
| For some allergies, immunotherapy may be used to | | | | Epinephrine rapidly constricts the blood vessels, |
| desensitize the allergic patient to subsequent allergic | | | | relaxes the muscles in the airway and lungs, reverses |
| reactions. | | | | swelling, and stimulates heartbeat, thereby reversing |
| Avoidance | | | | the most dangerous effects of an anaphylactic |
| Avoiding identified allergens is critical for people who | | | | reaction. However, it does not replace medical help. |
| suffer from severe allergies. People who may be | | | | Epinephrine provides the patient with emergency |
| susceptible to anaphylaxis should make a point to | | | | therapy, but immediate follow-up care by medical |
| educate themselves about their allergen. For example, | | | | professionals will provide the patient with the full |
| those with food allergies should inquire about food | | | | treatment necessary to counter an anaphylactic |
| ingredients that may provoke a reaction, while people | | | | episode. The sooner a patient receives epinephrine, |
| suffering from latex allergy need to find out which | | | | the better that patient's chance of survival. Extra |
| consumer products contain latex. | | | | vigilance is also essential after an episode of |
| Many allergic reactions to medications can be avoided | | | | anaphylaxis. |
| by better communication among the physician, | | | | Side effects of epinephrine may include palpitations, |
| pharmacist, and patient—be sure to mention any | | | | tachycardia (an abnormally fast heartbeat), sweating, |
| drug allergies that you have. People with insect | | | | nausea and vomiting, and respiratory difficulty. |
| venom allergies should take basic precautions | | | | Cardiac arrhythmias may follow administration of |
| regarding footwear, clothing, and use of perfumes to | | | | epinephrine. Patients need to be carefully instructed |
| minimize potential contact with bees, fire ants, or | | | | by a physician about the circumstances under which |
| other stinging insects when engaging in outdoor | | | | this life-saving medication should be used. |
| activities. Those with medication allergies may want | | | | Many physicians also recommend that antihistamines |
| to wear an identification bracelet describing their | | | | such as diphenhydramine be administered to lessen |
| allergy. | | | | the symptoms of an allergic reaction, but |
| It is also important that the allergic person's family, | | | | antihistamines should only be taken in addition to |
| friends, and—in the case of children—teachers | | | | epinephrine for the treatment of anaphylaxis and |
| and schools know about and understand the | | | | should not be considered a substitute for it. Only |
| ramifications of the allergy, so that they can aid in | | | | epinephrine can halt the potentially deadly effects of |
| the prevention of anaphylaxis. | | | | anaphylaxis. |
| Emergency Treatment | | | | Biphasic Reaction |
| Severe allergic reactions are frequently unavoidable | | | | As many as 25% of people who have an |
| because foods may contain unknown ingredients, | | | | anaphylactic reaction will experience a recurrence in |
| insects range widely, and latex can be found almost | | | | the hours following the beginning of the reaction and |
| anywhere. Once anaphylaxis begins, the treatment of | | | | require further medical treatment, including additional |
| choice is an immediate injection of epinephrine, | | | | epinephrine injections.2-4 This secondary reaction is |
| sometimes called adrenaline, which is effective for 10 | | | | called biphasic, meaning two phases. |
| to 15 minutes, followed by emergency medical | | | | |