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epinephrine in anaphylaxis

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https://www.readbyqxmd.com/read/29238519/how-to-manage-anaphylaxis-in-primary-care
#1
REVIEW
Alberto Alvarez-Perea, Luciana Kase Tanno, María L Baeza
Anaphylaxis is defined as a severe life-threatening generalized or systemic hypersensitivity reaction characterized by rapidly developing airway and/or circulation problems. It presents with very different combinations of symptoms and apparently mild signs and can progress to fatal anaphylactic shock unpredictably. The difficulty in recognizing anaphylaxis is due, in part, to the variability of diagnostic criteria, which in turn leads to a delay in administration of appropriate treatment, thus increasing the risk of death...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29236793/diagnosis-and-treatment-of-anaphylaxis-there-is-an-urgent-needs-to-implement-the-use-of-guidelines
#2
Maria Luiza Kraft Köhler Ribeiro, Herberto José Chong, Nelson Augusto Rosario
Anaphylaxis is a severe, life-threatening generalized or systemic hypersensitivity reaction that requires rapid and adequate care. This study aimed to obtain an integrated view of the level of physicians' knowledge related with treatment of anaphylaxis in studies published within the last 5 years. Sixteen studies were found and four points were identified as of the great interest to the authors: (1) emergency pharmacological treatment, (2) epinephrine auto-injectors prescription, (3) knowledge of the main signs of anaphylaxis, and (4) admission of the patient to verify biphasic reactions...
December 7, 2017: Einstein
https://www.readbyqxmd.com/read/29178678/%C3%AE-%C3%A2-adrenoceptor-blockade-deteriorates-systemic-anaphylaxis-by-enhancing-hyperpermeability-in-anesthetized-mice
#3
Wei Yang, Toshishige Shibamoto, Yuhichi Kuda, Tao Zhang, Mamoru Tanida, Yasutaka Kurata
PURPOSE: Patients treated with propranolol, a nonselective β-adrenoceptor antagonist, develop severe anaphylaxis, but the mechanism remains unknown. We determined effects of β₁- and β₂-adrenoceptor antagonists on the anaphylaxis-induced increase in vascular permeability in mice. METHODS: In anesthetized ovalbumin-sensitized C57BL mice, mean arterial blood pressure (MBP) was measured, and Evans blue dye extravasation and hematocrit (Hct) were assessed at 20 minutes after antigen injection...
January 2018: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/29168013/clinical-features-and-treatment-of-pediatric-patients-with-drug-induced-anaphylaxis-a-study-based-on-pharmacovigilance-data
#4
Yan Xing, Hua Zhang, Shusen Sun, Xiang Ma, Roy A Pleasants, Huilin Tang, Hangci Zheng, Suodi Zhai, Tiansheng Wang
We assessed the clinical features and treatment of pediatric patients with drug-induced anaphylaxis in clinical settings. Pediatric drug-induced anaphylaxis cases collected by the Beijing Pharmacovigilance Database from 2004 to 2014 were analyzed. A total of 91 cases were identified. Drug-induced anaphylaxis was primarily caused by antibiotics (53%). Children of 0-5 years were more likely to develop cyanosis symptoms than children of 13-17 years (OR = 5.14, 95%CI [1.74, 15.20], P = 0.002). Children of 13-17 years were more likely to develop hypotension than children of 6-12 years (OR = 11...
November 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29151840/adherence-with-epinephrine-autoinjector-prescriptions-in-primary-care
#5
Elissa M Abrams, Alexander G Singer, Lisa Lix, Alan Katz, Marina Yogendran, F Estelle R Simons
Background: The aim of this study was to estimate primary adherence for epinephrine autoinjector (EA) prescriptions in primary care practices in Manitoba, Canada. Methods: A retrospective analysis of electronic medical record and administrative data was performed to determine primary adherence, defined as dispensation of a new EA prescription within 90 days of the date the prescription was written. Multivariable logistic regression models were used to test predictors of filling an EA prescription...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/29149860/anaphylactic-shock-with-methylprednisolone-sodium-succinate-in-a-child-with-short-bowel-syndrome-and-cow-s-milk-allergy
#6
Federica Porcaro, Maria Giovanna Paglietti, Antonella Diamanti, Francesca Petreschi, Alessandra Schiavino, Valentina Negro, Valentina Pecora, Alessandro Fiocchi, Renato Cutrera
BACKGROUND: Medications with methyl-prednisolone sodium succinate containing lactose, which potentially contains traces of cow's milk proteins (CMP), could cause allergic reactions or compromise treatment of acute allergic reactions in sensitized patients. CASE PRESENTATION: We describe the unusual case of a one-year-old child affected by short bowel syndrome and history of severe cow's milk allergy (CMA) and anaphylactic reaction due to intravenous administration of methyl-prednisolone sodium succinate (Solu-Medrol 40 mg, Pfizer)...
November 17, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29144278/time-trends-in-food-allergy-diagnoses-epinephrine-orders-and-epinephrine-administrations-in-new-york-city-schools
#7
Elizabeth Feuille, Cheryl Lawrence, Caroline Volel, Scott H Sicherer, Julie Wang
OBJECTIVES: To assess time trends in food allergy diagnoses, epinephrine autoinjector (EAI) prescriptions, and EAI administrations in the school setting. STUDY DESIGN: In this retrospective study, deidentified student data from the New York City Department of Health and Mental Hygiene, which oversees >1 million students in 1800 schools, were provided to investigators. Data from school years 2007-2008 to 2012-2013 pertaining to diagnoses of food allergy, student-specific EAI orders, and EAI administrations among students in New York City were analyzed for trends over time, via the use of ORs and χ(2) calculation...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29123862/management-of-maternal-anaphylaxis-in-pregnancy-a-case-report
#8
Yasunobu Tsuzuki, Mitsuo Narita, Masayuki Nawa, Urara Nakagawa, Toshiaki Wakai
Case: A 26-year-old woman (gravida 2, para 1) at 25 weeks' gestation was brought to the emergency department because of anaphylactic symptoms. She reported eating Japanese soba and developed symptoms of dyspnea, generalized itchy rash, abdominal pain, and severe uterine contractions within 15-30 min of eating. She was immediately treated by normal saline infusion, two injections of epinephrine (intramuscularly), and a nebulized short-acting β2-receptor agonist, followed by H1-antihistamine and methylprednisolone...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29104573/endothelial-regulator-of-calcineurin-1-promotes-barrier-integrity-and-modulates-histamine-induced-barrier-dysfunction-in-anaphylaxis
#9
Constanza Ballesteros-Martinez, Nerea Mendez-Barbero, Alma Montalvo-Yuste, Bettina M Jensen, Aída Gomez-Cardenosa, Lotte Klitfod, María Garrido-Arandia, Gloria Alvarez-Llamas, Carlos Pastor-Vargas, Fernando Vivanco, Lene Heise Garvey, Javier Cuesta-Herranz, Lars K Poulsen, Vanesa Esteban
Anaphylaxis, the most serious and life-threatening allergic reaction, produces the release of inflammatory mediators by mast cells and basophils. Regulator of calcineurin 1 (Rcan1) is a negative regulator of mast-cell degranulation. The action of mediators leads to vasodilation and an increase in vascular permeability, causing great loss of intravascular volume in a short time. Nevertheless, the molecular basis remains unexplored on the vascular level. We investigated Rcan1 expression induced by histamine, platelet-activating factor (PAF), and epinephrine in primary human vein (HV)-/artery (HA)-derived endothelial cells (ECs) and human dermal microvascular ECs (HMVEC-D)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29103454/management-of-anaphylaxis
#10
REVIEW
Stella E Lee
Anaphylaxis is a severe systemic reaction that can be managed appropriately with expedient diagnosis and treatment. Intramuscular epinephrine continues to be the mainstay of treatment of anaphylaxis; however, it is still underused in the community and in the medical setting. Further education and counseling of patients and health care providers is required to prevent and manage anaphylaxis successfully. In-office management of anaphylaxis includes training of staff, preparedness with the necessary supplies and medication, and an effective action plan...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29098135/antidote-or-poison-a-case-of-anaphylactic-shock-after-intra-articular-corticosteroid-injection
#11
Pooja Sethi, Jennifer Treece, Chidinma Onweni, Vandana Pai
Although glucocorticoids are often used as an adjunct to epinephrine to treat anaphylactic shock, glucocorticoids can also be a rare cause of anaphylactic shock. Only through the administration of a challenge dose of different glucocorticoids and different substrates that glucocorticoids are delivered in can the determination be made about which glucocorticoid or accompanying solvent may be the culprit which caused the anaphylactic reaction. These challenge tests should only be performed in a controlled environment as repeat anaphylaxis is a risk, especially if the patient has a history of glucocorticoid-induced anaphylaxis...
August 29, 2017: Curēus
https://www.readbyqxmd.com/read/29070274/long-term-omalizumab-use-in-the-treatment-of-exercise-induced-anaphylaxis
#12
Mark R Peterson, Christopher A Coop
Reported is a case of a 39-year-old male who was diagnosed with exercise-induced anaphylaxis (EIA). He was initially treated prophylactically with fexofenadine, montelukast, and ranitidine. He also used an epinephrine autoinjector as needed. He was refractory to these medications and continued to have episodes of EIA. He was then started on a trial of omalizumab, an immunoglobulin E monoclonal antibody, and had resolution of the EIA episodes. After discontinuation of the omalizumab, the EIA episodes returned...
October 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/29040433/low-end-tidal-co2-as-a-real-time-severity-marker-of-intra-anaesthetic-acute-hypersensitivity-reactions
#13
A Gouel-Chéron, L de Chaisemartin, F Jönsson, P Nicaise-Roland, V Granger, A Sabahov, M-T Guinnepain, S Chollet-Martin, P Bruhns, C Neukirch, D Longrois
Background: Prompt diagnosis of intra-anaesthetic acute hypersensitivity reactions (AHR) is challenging because of the possible absence and/or difficulty in detecting the usual clinical signs and because of the higher prevalence of alternative diagnoses. Delayed epinephrine administration during AHR, because of incorrect/delayed diagnosis, can be associated with poor prognosis. Low end-tidal CO2 (etCO2) is known to be linked to low cardiac output. Yet, its clinical utility during suspected intra-anaesthetic AHR is not well documented...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29037819/drug-induced-paradoxical-vocal-fold-motion
#14
Marlene Garcia-Neuer, Donna Marie Lynch, Kathleen Marquis, Jayme Dowdall, Mariana Castells, David Edward Sloane
Vocal cord dysfunction, also known as paradoxical vocal fold motion (PVFM), is a disorder characterized by abnormal vocal cord adduction during inspiration. PVFM is commonly misdiagnosed as asthma because of the similarity of symptoms: cough, wheezing, chest pain, and dyspnea. We present the clinical vignette of a 36-year-old woman with juvenile rheumatoid arthritis and multiple adverse drug reactions who presented with recurrent episodes of unrecognized PVFM during skin testing for drug allergy, omalizumab treatment, and tocilizumab desensitization...
October 13, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29017902/small-percentage-of-anaphylactic-reactions-treated-with-epinephrine-during-food-challenges-in-dutch-children
#15
Johanna P M van der Valk, Irene Berends, Roy Gerth van Wijk, Nicolette J T Arends, Maurits S van Maaren, Hans de Groot, Harry J Wichers, Joyce A M Emons, Anthony E J Dubois, Nicolette W de Jong
BACKGROUND: Severe allergic reactions, including anaphylaxis, occur during oral food challenges (OFCs) and the first-line treatment of anaphylaxis is epinephrine. OBJECTIVE: To evaluate the percentage of anaphylactic reactions treated with epinephrine during OFCs and to identify associated factors for the administration of epinephrine. METHODS: Children who underwent an OFC with peanut, hazelnut, cow's milk, hen's egg, or cashew nut from 2005 through 2015 in the Netherlands were evaluated...
October 7, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28965631/drug-induced-anaphylaxis
#16
REVIEW
Marcelo Vivolo Aun, Jorge Kalil, Pedro Giavina-Bianchi
Drugs are among the main triggers of anaphylaxis, but identification of the culprit drug is frequently difficult. To confirm diagnosis of the causative agent, medical records and clinical history are fundamental. There are a few in vitro tests available in clinical practice, such as serum-specific IgE and basophil activation test. Skin tests are often useful for the diagnosis, although drug challenge is indicated in patients with inconclusive clinical history or to provide safe alternatives. Treatment of anaphylaxis is standard and intramuscular epinephrine is the main agent to prevent morbidity and mortality...
November 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28958374/contemporary-issues-in-anaphylaxis-and-the-evolution-of-epinephrine-autoinjectors-what-will-the-future-bring
#17
Paul A Greenberger, Dana V Wallace, Phillip L Lieberman, Sean M Gregory
BACKGROUND: Food allergy and anaphylaxis appear to be increasing in the United States, especially in young children, and preparedness is paramount to successful emergency management in the community. Although the treatment of choice for anaphylaxis is epinephrine delivered by autoinjection, some devices are challenged by less user-friendly designs or pose the risk of injury, especially in young patients. Human factors engineering has played a larger role in the development of more recent epinephrine autoinjector technologies and will continue to play a role in the evolution and future design of epinephrine autoinjectors...
October 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28956131/biphasic-and-protracted-anaphylaxis-to-iodinated-contrast-media
#18
Tae-Hyung Kim, Soon Ho Yoon, Suh-Young Lee, Young Hun Choi, Chang Min Park, Hye-Ryun Kang, Sang-Heon Cho
OBJECTIVES: To investigate the prevalence of biphasic and protracted anaphylaxis to iodinated contrast media (ICM), their risk factors and practical observation duration for detecting biphasic reaction. METHODS: 145 patients with ICM anaphylaxis from January 2005-February 2016 were retrospectively categorised into uniphasic, biphasic (anaphylaxis recurrence within 72 h after resolution of initial anaphylaxis) and protracted (anaphylaxis >5 h) reaction groups...
September 27, 2017: European Radiology
https://www.readbyqxmd.com/read/28941390/severe-forms-of-food-allergy
#19
REVIEW
Emanuel Sarinho, Maria das Graças Moura Lins
OBJECTIVES: To guide the diagnostic and therapeutic management of severe forms of food allergy. DATA SOURCES: Search in the Medline database using the terms "severe food allergy," "anaphylaxis and food allergy," "generalized urticaria and food allergy," and "food protein-induced enterocolitis syndrome" in the last ten years, searching in the title, abstract, or keyword fields. SUMMARY OF DATA: Food allergy can be serious and life-threatening...
November 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28941221/how-well-do-rheumatology-fellows-manage-acute-infusion-reactions-a-pilot-curricular-intervention
#20
Jason J Weiner, Amanda M Eudy, Lisa G Criscione-Schreiber
BACKGROUND: Infusible DMARDs are commonly prescribed in rheumatology and other fields. There are no published formal educational curricula rheumatology fellowship programs can use to teach infusion reaction management skills to fellows. We aimed to better understand this educational gap, and implement and assess the effectiveness of an experiential curriculum on acute infusion reaction management. METHODS: We included current rheumatology fellows and recent graduates from five fellowship programs...
September 21, 2017: Arthritis Care & Research
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