Treating anaphylaxis Essay

This essay has a total of 867 words and 5 pages.

treating anaphylaxis



TREATING ANAPHYLAXIS

In the emergency setting, anaphylaxis is a dangerous, life threatening condition that must
be treated in an aggressive and timely fashion. Anaphylaxis is a condition related to
acute allergic reactions. Following the body’s exposure to the offending allergen, there
are common systemic reactions. The most serious reactions involve the respiratory and
cardiovascular systems, but the gastrointestinal, dermatologic, and genitourinary systems
are often involved causing varied symptoms such as urticaria, flushing, angioedema,
bronchospasm, hypotension, cardiac arrythmias, nausea, intestinal cramps, pruritus, and
finally uterine cramps. (Physician Assistant, 8/94) The above list is by no means
exhaustive, specific symptoms vary from person to person. The same person suffering from
several anaphylactic reactions can also present with differing symptoms.

Physiologically speaking, the two main effects of the body’s released mediators (IgE)
during an anaphylactic reaction are smooth muscle contraction and vasodilatation, which
cause most of the body’s adverse symptoms. (JAMA, 11/26/82) Since the most life
threatening reactions usually involve the respiratory and cardiovascular systems, that is
where emergency treatment is focused. In the cardiovascular system, a combination of
vasodilatation, increased vascular permeability, tachcycardia, and arrhythmias can lead to
severe hypotension. In the respiratory system, the swelling of tissues along with
bronchospasm and increased mucus production are the main cause of death. So, if untreated,
anaphylaxis can be fatal as a result of the body’s going into what is essentially shock,
while simultaneously (and more importantly) being deprived of the oxygen needed to sustain
life.

As of today there is one universally accepted treatment for acute anaphylaxis.
Epinephrine. Epinephrine is both an alpha and a beta agonist. This makes it the drug
optimally suited to treat anaphylaxis. "Epinephrine will increase vascular resistance,
reduce vascular permeability, produce bronchodilation and increase cardiac output."
(Emergency, 10/93)

Epinephrine will directly counteract the potentially life threatening aspects of
anaphylaxis. Epinephrine can , and is, used in the both the pre-hospital environment as
well as in definitive care institutions. Epinephrine is widely administered by ALS
providers the world over. The drug is so effective that and relatively simple to use that
"…subcutaneous administration of epinephrine by EMT-B’s trained in recognition … of
anaphylaxis… is safe." (Annals of Emergency Medicine, 6/95)

Following the administration of epinephrine, antihistamines such as diphenhydramine,
hydroxyzine, and promethazine can be administered. These agents block the harmful effects
of histamine, a mediator associated with allergic reactions, and while not displacing
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