Who needs to carry an epinephrine autoinjector?

Abstract

A naphylaxis is potentially fatal but can be prevented if the trigger is identifi ed and avoided, and death can be avoided if episodes are treated promptly. A consensus defi nition of anaphylaxis has been diffi cult to achieve, with slight variations among international guidelines. The World Allergy Organization classifi es anaphylaxis as immunologic, nonimmunologic, or idiopathic. 1 The National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network highlight clinical symptoms and criteria. 2 The International Consensus on Food Allergy describes reactions as being immunoglobulin E (IgE)-mediated, cell-mediated, or a combination of the 2 mechanisms. 3 Despite the subtle differences in these definitions, all 3 international organizations have a common recommendation for anaphylaxis: once it is diagnosed, epinephrine is the treatment of choice. ■ EPINEPHRINE IS THE TREATMENT OF CHOICE FOR ANAPHYLAXIS Anaphylaxis commonly results from exposure to foods, medications, and Hymenoptera venom. 4 Avoiding triggers is key in preventing anaphylaxis but is not always possible. Although epinephrine is the cornerstone of the emergency treatment of anaphylaxis, many patients instead receive antihistamines and corticosteroids as initial therapy. Some take these medications on their own, and some receive them in emergency departments and outpatient clinics. 5 Diphenhydramine, a histamine 1 receptor antagonist, is often used as a fi rst-line medication. But diphenhydramine has a slow onset of action, taking 80 minutes after an oral dose REVIEW Dr. Song has disclosed membership on advisory committees or review panels for Allergopharma, and teaching and speaking for Novartis and Teva. Dr. Lieberman has disclosed consulting for Kaléo.

Anafilaxia en pediatría

“…Como ya se ha mencionado, la administración de epinefrina a una dosis de 0,01 mg / kg (1: 1000) es el tratamiento de primera línea para la anafilaxia (6,7,16,17,18,19). No existe ninguna contraindicación absoluta para este tratamiento (7,12).…”

“…Los corticosteroides también tienen un inicio de acción lento. Estos medicamentos no pueden prevenir la muerte por anafilaxia (18). FIGURA 1.…”

Gestão do cuidado seguro da criança alérgica ao leite: a saúde do escolar e suas perspectivas

“…Foi apontada como medida para melhorar a comunicação, a criação de Programas de conscientização sobre alergia na comunidade, implementando ações conjuntas com as famílias, escolas e profissionais de saúde para garantir treinamento, informação e um melhor gerenciamento da criança alérgica alimentar (Grief, 2016;Kao et al, 2018;Pouessel et al, 2017;Robinson et al, 2017;Sicherer et al, 2017;Tanner & Clarke, 2016;Urrutia-Pereira et al, 2018;Vale et al, 2013Vale et al, , 2015. Outra ação de segurança descrita foi a comunicação com a equipe de nutrição (Pouessel et al, 2017) e com os médicos responsáveis, pois precisam dar orientações aos pacientes e familiares como evitar o contato com os alérgenos e para que saibam reconhecer sinais e sintomas de anafilaxia (Song & Lieberman, 2019).…”

“…Visitas regulares aos alergistas e prescrição de caneta de adrenalina atualizada (Cabrera et al, 2017;Feuille et al, 2017) foram ações apontadas como medida de segurança para criança, além da necessidade de administração de adrenalina precocemente (Dumeier et al, 2018;Song & Lieberman, 2019;Urrutia-Pereira et al, 2018), que pode ser garantido através de estoque de epinefrina nas escolas (Cabrera et al, 2017;DeSantiago-Cardenas et al, 2015;Moritz & Schoessler, 2018;Portnoy & Shroba, 2014;Schoessler & White, 2013;Steffens et al, 2017;Szychlinski et al, 2015;Tsuang & Wang, 2016;White et al, 2017;Zadikoff et al, 2014) e também pelo porte de auto injetores de adrenalina pelo estudante (Chipps, 2013;Solé et al, 2018).…”

Winning the war against anaphylaxis requires continued professional patient manegement till discharge

“…4 Adrenaline administration has been the first-line intervention after diagnosis. 5 Several guidelines have recently been released in an effort to alleviate this global health concern; emphasizing the importance of the provision of adrenaline auto-injectors (AAIs), appropriate counselling and education of the patients (and caregivers where relevant) and of doctors. 6 Still anaphylaxis related fatality rates have remained stable or decreased only slightly even after several amendments in the treatment protocols.…”