Anaphylaxis (Severe Allergic Reaction)

  • Medical Author:
    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

View 10 Common Allergy Triggers Slideshow Pictures

Quick Guide10 Common Allergy Causes

10 Common Allergy Causes

Is it possible to prevent anaphylaxis?

Preventing anaphylaxis is the ideal form of treatment. However, that may not always be easy since insect stings are frequently unanticipated, and allergens in foods are often hidden in a variety of different preparations. A consultation with an allergist is vital in helping one identify the trigger(s) and providing information and instruction on how to best avoid them. The affected individual 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.

  1. 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.
  2. Premedication is most helpful in preventing anaphylaxis from X-ray dyes. Alternative dyes that are less likely to cause reactions may be available.
  3. 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.

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
TriggerAvoidance Principle
Drugs/medications
  • Advise all health-care personnel of any allergies.
  • Ask a doctor whether the prescribed medication contains the drug(s) one is 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.
  • Many candy bars will now indicate if they were produced in a peanut-free environment.
  • Ask what the ingredients are when eating out.
  • Speak directly with the cook/chef to assure that cooking utensils are not used for the preparation of other dishes that one may be allergic to.
  • Avoid foods that may cross-react, such as bananas, kiwi fruit, and avocado.
Latex
  • Avoid all latex products.
  • Make sure the hospital or doctor's office has latex-free supplies.

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:

  • EpiPen is a spring-loaded automatic syringe that delivers a predetermined dose (0.3 mg) when the tip is pressed hard for several seconds. An EpiPen junior is available for children under 33 pounds and contains half of the dose.
  • Ana-kit contains a preloaded syringe and needles with two 0.3 mg 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 a 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 readily available.
  • Make sure that friends, relatives, exercise buddies, and coworkers are aware of one's condition and know what to do in case of a reaction.

REFERENCE:

Tintinalli, Judith E., ed. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York: McGraw-Hill, 2011.

Medically Reviewed by a Doctor on 6/24/2015

Subscribe to MedicineNet's Allergy and Asthma Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

VIEW PATIENT COMMENTS
  • Anaphylaxis - Describe Your Experience

    Please describe your experience with anaphylaxis.

    Post View 36 Comments
  • Anaphylaxis - Symptoms and Signs

    What symptoms and signs did you experience with anaphylaxis?

    Post View 19 Comments
  • Anaphylaxis - Possible Causes

    Do you know what caused your case of anaphylaxis? Please share your experience.

    Post View 5 Comments
  • Anaphylaxis - Diagnosis

    Discuss the events that led to a diagnosis of anaphylaxis. Did you end up in the ER?

    Post View 5 Comments
  • Anaphylaxis - Prevention

    If you've experienced anaphylaxis, how do you prevent another occurrence? Do you have an EpiPen?

    Post View 2 Comments
  • Anaphylaxis - Treatment

    What kind of treatment did you get for anaphylaxis?

    Post

Health Solutions From Our Sponsors