Anaphylaxis (cont.)
Can anaphylaxis be prevented?
Preventing anaphylaxis is the ideal form of treatment.
However, that may not always be easy since insect stings
are frequently unanticipated and allergic foods are often
hidden in a variety of different preparations. A
consultation with an allergist is vital in helping you
identify the trigger(s) and providing you with information
and instruction on how to best avoid them. You will learn
how to use emergency kits and how to become prepared for
any reaction in the future.
These are three situations in which preventive treatment
might be offered by the allergist.
- Allergy shots may be suggested to some people with
wasp, yellow jacket, hornet, honey bee, or fire ant
reactions. This form of treatment gives 98% protection
against the first four insect reactions, though somewhat
less
protection against fire ant reactions.
- Pre-medication is most helpful in preventing
anaphylaxis from x-ray dyes. Alternative dyes that are
less likely to cause reactions may be available.
- Desensitization to problematic medications is often
effective. This process is accomplished by gradually
increasing the amount of the medication given under
controlled conditions. Sensitivities to penicillin, sulfa
drugs, and insulin have been successfully treated in this
way.
Anyone known to be at risk for anaphylaxis should wear a
Medic-Alert bracelet that clearly states the allergic
trigger, the risk of anaphylaxis, and the availability of
an epinephrine kit.
Allergy Assist
People with anaphylaxis to medications should take new
medications by mouth whenever possible since the risk of anaphylaxis is higher
with injections.
Table 2: Basic Avoidance Measures for
Anaphylaxis
| Trigger
| Avoidance Principle
|
| Drugs/Medications
| - Advise all health care personnel of
your
allergies.
- Ask your doctor whether the prescribed medication
contains the drug(s) you are allergic to.
- Take all drugs by mouth if possible.
|
| Insect Stings
| - Avoid areas such as outdoor garbage,
barbecues,
and insect nests.
- Avoid bright clothing, perfume, hair
spray or
lotion that might attract insects.
- Wear long sleeved clothing, long trousers, and shoes
while
outdoors
|
| Food
| - Carefully read all labels.
- Ask what the ingredients are when eating out.
- Avoid foods that may cross react such as bananas, kiwi
fruit, and
avocado.
|
| Latex
| - Avoid all Latex products.
- Ask if
your
hospital has Latex safety issues if you need to be
hospitalized.
|
Since avoidance is not fail safe, a person at risk for
an anaphylactic reaction must be adequately prepared in an
emergency to handle a reaction. It is recommended that
everyone at risk carry epinephrine injection kits designed
for self-administration. These kits are available by
prescription only and come in two forms:
- Epi-pen is a spring-loaded automatic syringe that
delivers a predetermined dose (0.3mg) when the tip is
pressed hard for several seconds. An Epi-pen junior is
available for children under 33 pounds and contains half of
the dose.
- Ana-kit contains a preloaded syringe and needles with two
0.3mg doses of epinephrine. These are injected under the
skin or into the muscle of the thigh. An antihistamine,
alcohol swab, and a tourniquet are included in the kit.
Here are some important points to remember regarding the
kits:
- Ask you doctor to explain the use of the kit carefully
and practice with the demonstrator kit.
- Check expiration dates and replace outdated kits.
- Keep kits out of direct sunlight, which may affect the
drug.
- Additional kits should be brought to school or
work.
- Always have kits with you or readily available.
- Make sure that your friends, relatives, exercise
buddies, and co-workers are aware of your condition and
know what to do in case of a reaction.
- Anaphylaxis is the most severe allergic reaction and is
potentially life threatening.
- Anaphylaxis is rare. The vast majority of people will
never have an anaphylactic reaction.
- The most common causes of anaphylaxis include drugs,
such as penicillin, insect stings, foods, x-ray dye, latex,
and exercise.
- The symptoms of anaphylaxis may vary from hives, tongue
swelling, and vomiting, to shock.
- If you are at risk, avoidance is the best form of
treatment.
- If you have a history of serious allergic reaction, always have an epinephrine kit available - it could
save your life.
Last Editorial Review: 5/30/2007
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