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epinephrine in anaphylaxis

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https://www.readbyqxmd.com/read/29449164/patients-taking-%C3%AE-blockers-do-not-require-increased-doses-of-epinephrine-for-anaphylaxis
#1
Jennifer L White, Katie C Greger, Sangil Lee, Robert J Kahoud, James T Li, Christine M Lohse, Ronna L Campbell
BACKGROUND: β-Blocker use has been associated with increased anaphylaxis severity. OBJECTIVE: We aimed to assess for an association between β-blocker use and requirement for more than 1 dose of epinephrine for anaphylaxis management. METHODS: We conducted a retrospective observational study of patients seen in our emergency department for anaphylaxis between April 2008 and January 2015. The primary outcome measure was the number of doses of epinephrine...
February 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29439456/epinephrine-in-anaphylaxis-preclinical-study-of-pharmacokinetics-after-sublingual-administration-of-taste-masked-tablets-for-potential-pediatric-use
#2
Ousama Rachid, Mutasem Rawas-Qalaji, Keith J Simons
Epinephrine is a life-saving treatment in anaphylaxis. In community settings, a first-aid dose of epinephrine is injected from an auto-injector (EAI). Needle phobia highly contributes to EAI underuse, leading to fatalities-especially in children. A novel rapidly-disintegrating sublingual tablet (RDST) of epinephrine was developed in our laboratory as a potential alternative dosage form. The aim of this study was to evaluate the sublingual bioavailability of epinephrine 30 mg as a potential pediatric dose incorporated in our novel taste-masked RDST in comparison with intramuscular (IM) epinephrine 0...
February 11, 2018: Pharmaceutics
https://www.readbyqxmd.com/read/29415679/downstream-consequences-of-diagnostic-error-in-pediatric-anaphylaxis
#3
H Thomson, R Seith, S Craig
BACKGROUND: Pediatric anaphylaxis is commonly misdiagnosed in the Emergency Department (ED). We aimed to determine the impact of inaccurate diagnosis on the management and follow-up of pediatric anaphylaxis presenting to the ED. METHODS: Retrospective chart review of ED management of children aged 0-18 years with allergic presentations to three EDs in Melbourne, Australia in 2014. Cases were included if an ED diagnosis of anaphylaxis was recorded, or the presentation met international consensus criteria for anaphylaxis...
February 7, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29411554/are-registration-of-disease-codes-for-adult-anaphylaxis-accurate-in-the-emergency-department
#4
Byungho Choi, Sun Hyu Kim, Hyeji Lee
PURPOSE: There has been active research on anaphylaxis, but many study subjects are limited to patients registered with anaphylaxis codes. However, anaphylaxis codes tend to be underused. The aim of this study was to investigate the accuracy of anaphylaxis code registration and the clinical characteristics of accurate and inaccurate anaphylaxis registration in anaphylactic patients. METHODS: This retrospective study evaluated the medical records of adult patients who visited the university hospital emergency department between 2012 and 2016...
March 2018: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/29408441/value-of-a-second-dose-of-epinephrine-during-anaphylaxis-a-patient-caregiver-survey
#5
T Ted Song, Duncan Brown, Martin Karjalainen, Ulrike Lehnigk, Phil Lieberman
BACKGROUND: Anaphylaxis guidelines recommend prescription of >1 epinephrine auto-injector (EAI) for patients at risk. A second epinephrine dose is required in 16 to 36% of patients. OBJECTIVE: Evaluate real-world use of EAIs and understand the patients/caregivers' adherence to guidelines. METHODS: We collected survey responses from United States patients and caregivers with an EAI prescription in November 2015. The survey covered several domains relevant to anaphylaxis and EAI use...
February 2, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29407420/changes-in-emergency-department-concordance-with-guidelines-for-the-management-of-stinging-insect-induced-anaphylaxis-1999-2001-versus-2013-2015
#6
Sunday Clark, Krislyn M Boggs, Diana S Balekian, Kohei Hasegawa, Phuong Vo, Brian H Rowe, Carlos A Camargo
BACKGROUND: Changes in emergency department (ED) concordance with guidelines for the management of stinging insect-induced anaphylaxis (SIIA) are not known. OBJECTIVE: We describe temporal changes in ED concordance with guidelines for the management of SIIAs. METHODS: We analyzed data from two multicenter retrospective studies of patients with stinging insect-related acute allergic reactions seen in one of 14 North American EDs during two time periods: 1999-2001 and 2013-2015...
January 30, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29406471/life-threatening-accidental-intravenous-epinephrine-overdose-in-a-12-year-old-boy
#7
Maya Caroline André, Jürg Hammer
Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (intravenous instead of intramuscular). He reacted with acute loss of consciousness and acute cardiorespiratory failure due to arterial hypotension, ischemic heart failure, and severe pulmonary edema...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29364730/improving-prehospital-protocol-adherence-using-bundled-educational-interventions
#8
Megan C Marino, Daniel G Ostermayer, Juan A Mondragon, Elizabeth A Camp, Elizabeth M Keating, Louis B Fornage, Charles A Brown, Manish I Shah
BACKGROUND: Seizures and anaphylaxis are life-threatening conditions that require immediate treatment in the prehospital setting. There is variation in treatment of pediatric prehospital patients for both anaphylaxis and seizures. This educational study was done to improve compliance with pediatric prehospital protocols, educate prehospital providers and decrease variation in care. OBJECTIVE: To improve the quality of care for children with seizures and anaphylaxis in the prehospital setting using a bundled, multifaceted educational intervention...
January 24, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29351501/pediatric-anaphylaxis-in-the-prehospital-setting-incidence-characteristics-and-management
#9
Emily Andrew, Ziad Nehme, Stephen Bernard, Karen Smith
OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29338154/characteristics-etiology-and-treatment-of-pediatric-and-adult-anaphylaxis-in-iran
#10
Mohammad Nabavi, Mehrnoosh Lavavpour, Saba Arshi, Mohammad Hasan Bemanian, Hossein Esmaeilzadeh, Rasool Molatefi, Mahsa Rekabi, Javad Ahmadian, Narges Eslami, Sima Shokri, Kian Darabi, Gholam Reza Sedighi, Morteza Fallahpour
Despite the increasing prevalence of anaphylaxis, there is little information about the characteristics and practice of healthcare providers in treating anaphylaxis, so this study was conducted to record the characteristics and therapeutic approaches of anaphylaxis from May 2012 until April 2015, the data of all patients diagnosed with anaphylaxis in the Allergy department of three referral university hospitals in Tehran, Iran were recorded. Thereafter, the demographics, clinical features, triggers and therapeutic approach were evaluated...
December 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/29336638/prehospital-administration-of-epinephrine-in-pediatric-anaphylaxis-a-statewide-perspective
#11
Leslie M Cristiano, Brian Hiestand, Jason W Caldwell, W Adam Gower, Antonio R Fernandez, Katherine Gilbert, James E Winslow
OBJECTIVE: Timely administration of epinephrine is critical in the treatment of anaphylaxis. This study sought to determine the frequency of administration of epinephrine by EMS providers caring for pediatric patients in the prehospital setting. METHODS: We examined data from the NC EMS database (PreMIS) from 2010-3 to determine frequency of epinephrine administration in pediatric patients with anaphylaxis. We studied patients <18 years of age with an EMS provider impression of "allergic reaction...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29333893/syringe-administration-of-epinephrine-by-emergency-medical-technicians-for-anaphylaxis
#12
Andrew J Latimer, Sofia Husain, Jonathan Nolan, Vinod Doreswamy, Thomas D Rea, Michael R Sayre, Mickey S Eisenberg
OBJECTIVE: In recent years, the costs of epinephrine autoinjectors (EAIs) in the United States have risen substantially. King County Emergency Medical Services implemented the "Check and Inject" program to replace EAIs by teaching emergency medical technicians (EMTs) to manually aspirate epinephrine from a single-use 1 mg/mL epinephrine vial using a needle and syringe followed by prehospital intramuscular administration of the correct adult or pediatric dose of epinephrine for anaphylaxis or serious allergic reaction...
January 15, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29277095/management-and-educational-status-of-adult-anaphylaxis-patients-at-emergency-department
#13
Mi-Yeong Kim, Chan Sun Park, Jae-Won Jeong
Background/Aims: We evaluated the management and educational status of adult anaphylaxis patients at emergency departments (EDs). Methods: Anaphylaxis patients who visited ED from 2011 to 2013 were enrolled from three hospitals. We analyzed clinical features, prior history of anaphylaxis, management and provided education for etiology and/or prevention. For analyzing associated factors with epinephrine injection, Pearson chi-square test was used by SPSS version 21 (IBM Co...
December 28, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29258790/the-allergist-s-role-in-anaphylaxis-and-food-allergy-management-in-the-school-and-childcare-setting
#14
Julie Wang, Theresa Bingemann, Anne F Russell, Michael C Young, Scott H Sicherer
Anaphylaxis and food allergy management in childcare facilities and schools are growing challenges. An increasing number of children experience severe allergic reactions on school grounds as evidenced by reports of epinephrine use. Data also suggest that the prevalence of food allergy may be increasing, with a large percentage of school-aged children at risk for anaphylaxis. Moreover, anaphylaxis may occur for the first time in a previously undiagnosed child at school or childcare setting, suggesting that general preparedness is essential...
December 16, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29238519/how-to-manage-anaphylaxis-in-primary-care
#15
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
#16
Maria Luiza Kraft Köhler Ribeiro, Herberto José Chong Neto, Nelson Augusto Rosario Filho
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...
October 2017: Einstein
https://www.readbyqxmd.com/read/29178678/%C3%AE-%C3%A2-adrenoceptor-blockade-deteriorates-systemic-anaphylaxis-by-enhancing-hyperpermeability-in-anesthetized-mice
#17
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
#18
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
#19
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
#20
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
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