immunology allergic disorders
Anaphylaxis
Key Points
Common triggers of anaphylaxis include drugs (eg, beta-lactam antibiotics, allergen extracts), foods (eg, nuts, seafood), proteins (eg, tetanus antitoxin, blood transfusions), animal venoms, and latex. Non–IgE-mediated reactions that have anaphylactic-like manifestations (anaphylactoid reactions) can be caused by an iodinated radiopaque contrast agent,aspirin, other nonsteroidal anti-inflammatory drugs, opioids, monoclonal antibodies, and exercise. Consider anaphylaxis if patients have unexplained hypotension, respiratory symptoms, or ≥ 2 anaphylactic manifestations (eg, angioedema, rhinorrhea, gastrointestinal symptoms). Giveepinephrineimmediately because anaphylactic symptoms may rapidly progress to airway occlusion or shock;epinephrinecan help relieve all symptoms. Instruct patients to always wear an alert bracelet and carry a prefilled, self-injectingepinephrinesyringe for prompt self-treatment after exposure. 