2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines

Simons, F. Estelle R.; Ebisawa, Motohiro; Sánchez‐Borges, Mario; Thong, Bernard Yu‐Hor; Worm, Margitta; Tanno, Luciana Kase; Lockey, Richard F.; El-Gamal, Yehia; Brown, Simon G A; Park, Hae‐Sim; Sheikh, Aziz

doi:10.1186/s40413-015-0080-1

Cited by 459 publications

(393 citation statements)

References 149 publications

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“…4). 1, 31, 32, 33 Early injection of adrenaline for anaphylaxis, defined as injection before ER arrival, can significantly reduce the likelihood of hospital admission, as compared with initial injection after arrival at the ER 34. Although no human studies regarding the timing of treatment for anaphylaxis could be found, analysis of 92 deaths related to anaphylaxis showed that adrenaline was given prior to cardiac arrest in only 22 of the cases (24%) 35.…”

Section: Initial Treatment Of Anaphylaxismentioning

confidence: 99%

“…This evidence supports the importance of early adrenaline injection. The beneficial effect of adrenaline results from its action on systemically distributed adrenaline receptors 32. Its α1 agonist vasoconstrictor effects prevent and relieve airway edema, hypotension, and shock; its β1 agonist chronotropic and ionotropic effects increase the rate and force of cardiac contractions, and its β2 agonist effects lead to bronchodilation.…”

Section: Initial Treatment Of Anaphylaxismentioning

confidence: 99%

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Drug‐induced anaphylaxis in the emergency room

Takazawa

Oshima

Saito

2017

Acute Medicine & Surgery

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Anaphylaxis is a life‐threatening, systemic allergic reaction that presents unique challenges for emergency care practitioners. Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis. To this end, the clinical criteria proposed by the National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network are useful, which, together with a differential diagnosis, could enable a more accurate diagnosis. Additional in vitro tests, such as plasma histamine and tryptase measurements, are also helpful. It should be emphasized that adrenaline is the only drug recommended as first‐line therapy in all published national anaphylaxis guidelines. Most international anaphylaxis guidelines recommend injecting adrenaline by the intramuscular route in the mid‐anterolateral thigh, whereas i.v. adrenaline is an option for patients with severe hypotension or cardiac arrest unresponsive to intramuscular adrenaline and fluid resuscitation. In addition to the route of administration, choosing the appropriate dose of adrenaline is essential, because serious adverse effects can potentially occur after an overdose of adrenaline. Furthermore, to avoid future recurrence of anaphylaxis, providing adrenaline auto‐injectors and making an etiological diagnosis, including confirmation of the offending trigger, are recommended for patients at risk of anaphylaxis before their discharge from the emergency room.

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Section: Initial Treatment Of Anaphylaxismentioning

confidence: 99%

Section: Initial Treatment Of Anaphylaxismentioning

confidence: 99%

Drug‐induced anaphylaxis in the emergency room

Takazawa

Oshima

Saito

2017

Acute Medicine & Surgery

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“…29 Las causas más comunes de la anafilaxia en los niños son: a) alimentos: leche, huevos, nueces, cacahuetes, soja y pescado; b) picadura de insecto: abejas y hormigas (himenópteros); y c) fármacos: antiinflamatórios no hormonales y antibióticos (betalactámicos). 30 Los síntomas comienzan entre cinco y 30 minutos después de la exposición al agente causal pero, excepcionalmente, pueden aparecer después de unas horas. La mayoría de las veces existe participación de la piel, las mucosas o ambas (urticaria generalizada, picazón o enrojecimiento, edema de los labios, lengua y úvula) y al menos uno de los siguientes síntomas:…”

Section: Reacción Anafiláticaunclassified

El niño alérgico en la escuela. ¿Qué es lo que se necesita saber?

Urrutia-Pereira

Solé

2016

RAM

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Allergy is a multisystem disease in children that often occurs with the coexistence of diverse clinical manifestations that cause great impact on quality of life and academic performance due to sleep disorders arising from the disease or treatment, and absenteeism that children may experience. Because of the time spent in school, there is a possibility that allergic reactions may occur first in these facilities, where a lack of staff knowledge has been found regarding how to proceed in allergy crisis situations. Cooperative action among health teams, community, parents, and school authorities is essential to ensure that the school can prevent, recognize, and ensure quick access to emergency services (if needed) and treatment protocols for allergic reactions, thus allowing allergic children to be better protected in the school environment, which should be considered an extension of the home environment and an important arm in proper management to control the disease. Keywords

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“…The antihistamines could be helpful in management of children with anaphylaxis as a second or third treatment line [74]. The intramuscular administration of the first generation antihistamines (e.g.…”

Section: Anaphylaxismentioning

confidence: 99%

The role and choice criteria of antihistamines in allergy management – Expert opinion

Kuna

Jurkiewicz

Czarnecka‐Operacz

et al. 2017

Alergologia Polska - Polish Journal of Allergology

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A b s t r a c tAllergic diseases are the most common chronic conditions lasting throughout the patient's life. They not only cause significant deterioration in the quality of life of patients but also lead to significant absenteeism and reduced productivity, resulting in very high costs for society. Effective and safe treatment of allergic diseases is therefore one of the main challenges for public health and should be carried out by all the specialists in family medicine, internists and paediatricians in collaboration with allergists, otorhinolaryngologists and dermatologists. Antihistamines are most commonly used in the treatment of allergies. Several dozen drugs are available on the pharmaceutical market, and their generic forms are advertised widely as very effective drugs for the treatment of allergic diseases. What is the truth? What are the data from clinical trials and observational studies? Are all drugs equally effective and safe for the patient? According to a panel of experts representing various fields of medicine, inappropriate treatment of allergies can be very risky for patients, and seemingly equally acting medications may differ greatly. Therefore, a panel of experts gathered the latest data from the entire scientific literature and analysed the latest standards and recommendations prepared by scientific societies. This paper provides a summary of these studies and highlights the importance for the patient of the proper choice of drug to treat his allergies.Key words: antihistamines, bilastin, allergic rhinitis, urticaria, allergy. Which antihistamines should be chosen according to current standards and recommendations?In the last few decades the incidence of allergic diseases has grown to epidemic status. According to the current data, more than 600 million people suffer from allergic rhinitis worldwide, approximately 25% of them in Europe. In the ECAP trial (Epidemiology of Allergic Diseases in Poland) as many as 30% of respondents reported allergic rhinitis, less than 7% mentioned urticaria, but over 40% of patients had positive skin tests with common inhaled allergens (e.g. plant pollen, dust mites, mould and animal hair). Despite this huge number of patients, these data are frequently underestimated, since allergic diseases are generally believed to be trivial and non-hazardous. However, it has already been proven that allergic rhinitis, asthma and urticaria are associated with a significant socioeconomic burden all over the world -regardless of region, development level and financial status. The total cost of allergic diseases brings both reduced quality of life and also direct costs of drugs and health services as well as indirect social costs such as the absence from work; it also decreases productivity and concentration and generates learning disorders and

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2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines

Cited by 459 publications

References 149 publications

Drug‐induced anaphylaxis in the emergency room

Drug‐induced anaphylaxis in the emergency room

El niño alérgico en la escuela. ¿Qué es lo que se necesita saber?

The role and choice criteria of antihistamines in allergy management – Expert opinion

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