ANAPHYLAXIS

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

ANAFILAXY is an immediate allergic reaction; Occurs when parenteral (bypassing the gastrointestinal tract) ingestion of an allergen into the body and often requires urgent care. Distinguish allergic reactions of the lungs and medium severity (pruritus, urticaria , allergic rhinitis , Quincke's edema) and severe (anaphylactic shock , asthmatic status).

Anaphylactic shock - the most formidable clinical variant of an acute allergic reaction - is most often observed after administration of penicillin. It can occur after the use of antibiotics, sulfonamides, vitamins, therapeutic serums, radiocontrast agents, etc., as well as after insect bites.

Immediately after the injection (or 20 to 40 minutes), the patient has a feeling of tightness in the chest, dizziness , headache , anxiety, agitation or depression, severe weakness, a feeling of heat in the body, abdominal pain, rash-like skin rashes and generalized Itching, rhinorrhea. At the same time there is suffocation, dry coughing , which is caused by the development of bronchospasm or edema of the larynx with the stridor breathing. In severe cases, symptoms of shock are expressed: pallor and marble skin color, acrocyanosis; Limbs become cold, the pulse is threadlike or not probed, the blood pressure falls or is not determined. With anaphylactic shock, the drop in blood pressure can be combined with the development of a coma. Seizures with the separation of foam from the mouth, involuntary urination - the consequence of severe hypoxia of the brain. In such cases, death may occur in a few minutes after the onset of shock. In less severe cases, the symptoms of fainting are observed in patients, combined with a mild bronchospasm and a drop in blood pressure.

Thus, the main manifestations of anaphylactic shock are:

  • Arterial hypotension and stunned with a mild course, collapse and loss of consciousness in severe conditions;

  • Violation of breathing due to edema of the larynx with the development of stridor or bronchospasm;

  • Abdominal pain, hives , itching.


Treatment . Emergency care for anaphylactic shock should be provided without delay, while the speed and precision of the appointments are required. Therefore, in the treatment rooms of polyclinics, ambulances, nursing and feldsher stations, it is necessary to have appropriate sets of medicines, disposable syringes and droppers. After providing emergency care, the patient must be hospitalized. It should be ensured:

  • The discontinuation of further ingestion of the suspected allergen is possible by applying a tourniquet above the site of injection of the drug that caused the allergic reaction, or by chopping and infiltrating the site of injection or bite with 0.3 ml of a 0.1% solution of epinephrine.

  • Subcutaneously inject 0.3-0.5 ml of a 0.1% solution of epinephrine, if necessary, injections are repeated every 20 minutes for an hour. With unstable hemodynamics with the development of an immediate threat to life, intravenous injection of epinephrine is possible.

  • Correction of arterial hypotension and replenishment of the circulating blood volume by means of transfusion of saline and colloidal solutions (500-1000 ml of isotonic sodium chloride solution, 400 ml of polyglucin). The use of vasopressor amines (dopamine, norepinephrine) is possible only after replenishing the volume of circulating blood.

  • At the same time, 125-250 mg of hydrocortisone or 60-150 mg of prednisolone or 4-8 mg of betamethasone (celeston) are administered intravenously, the administration of glucocorticoids can be repeated every 6 hours until the allergic reaction is stopped. Steroid hormones do not have immediate effect in the first 6-12 hours, but prevent recurrence of the reaction.

  • With the development of bronchospasm and inefficiency of epinephrine for its reduction, intravenous injection of 10 ml of a 2.4% solution of euphyllin with 10 ml of isotonic sodium chloride solution and beta-adrenomimetic inhalation (salbutamol, alupent) is indicated.


Prevention of anaphylaxis is reduced to a careful collection of an allergic medical history before the appointment of any medication.