Risks Of Anaphylaxis Reactions example essay topic

Anaphylaxis is a rapidly developing and serious reaction that affects a number of different areas of the body at once. Severe anaphylaxis shock can be fatal, although most people only experience allergy symptoms as a major annoyance. A small number of people are susceptible to a reaction that can lead to shock or death. Anaphylaxis rare and only one out of 2.5 million die annually. The term anaphylaxis goes back almost a hundred years. It began on Prince Albert I of Monaco's ship.

Prince Albert I had invited two scientists to perform studies on the toxin produced by the tentacles of jellyfish. Charles Richet and Paul Portier were able to isolate the toxin and tried to vaccinate dogs in hope of obtaining "prophylaxis" or protection from the toxin. To their dismay, they found that very small doses of the toxin resulted in a new illness that involved the rapid onset of labored breathing that resulted in death. Richet and Portier termed this anaphylaxis or "against protection". Their conclusion was that the immune system became sensitized to the allergen over a period of weeks. Then upon re-exposure, a severe reaction occurred.

Richet suggested that the allergen must result in the production of a substance which sensitized the dogs to react severely upon re-exposure. This substance turned out to be immunoglobulin E (IgE). In the early 20th century, anaphylactic reactions were most commonly caused by the tetanus vaccination. The vaccines were made from horse serum; today, human serum is used. Presently the most common causes of anaphylaxis are foods (eggs, seafood, nuts, grains, peanuts, milk), Drugs (penicillin, cephalosporins group), insect stings (bees, yellow jackets, wasps, hornets, fire ants), injected anesthetics (procaine, lidocaine), dyes (used in x-rays and scans), industrial chemicals (latex and rubber products used by healthcare workers) and allergy shots (immunotherapy). Peanut and tree nut allergies now account for a significant number of anaphylaxis.

1 Estimates of about ten thousand cases of anaphylaxis occur per year in the United States, with about 950 deaths per year. Foods cause around one hundred deaths, while insect stings cause about fifty deaths in a given year. The risks of anaphylaxis reactions may diminish over time if there are no repeated exposures or reactions. However, the person at risk should be prepared for the worst. The symptoms of anaphylaxis are numerous and general.

There are no universally excepted reactions. The symptoms of a reaction can occur within seconds or even can be delayed fifteen minutes to an hour or more as with aspirin. Early symptoms are often related to the skin. Flashing, itching, and hives are common initial findings. Additional signs include a feeling of doom or anxiety and a rapid pulse rate. Throat and tongue swelling resulting in difficult swallowing and breathing follow.

The patient may develop rhinitis or asthma which cause a runny nose, sneezing, and wheezing which can worsen breathing. Vomiting and stomach cramps may also develop. Some patients die from acute irreversible asthma or laryngeal edema with few other generalized symptoms. 2 Cardiovascular collapse is common with reactions to drugs and insect stings which is caused by vasodilation and loss of plasma from the blood.

Blood pressure drop, lightheadedness or loss of consciousness are signs of anaphylactic shock. There are three possible outcomes to anaphylaxis reactions. The symptoms may be mild and treated with antihistamines. The more severe cases that are potentially life threatening require immediate medical attention. If available, epinephrine should be given at the first signs of a serious reaction to slow the progression of symptoms.

Anaphylactic shock is treated with epinephrine and intravenous fluids. 3 The patient may also need oxygen treatment. Additional treatments include the intravenous use of antihistamines and corticosteroids which are considered slow acting drugs. After initial occurrence, the symptoms may return, but this is only in about ten percent of cases. The causes of anaphylaxis are divided into two major groups.

They include IgE mediated and non IgE mediated. In IgE mediated, which is the true form of anaphylaxis, there is a requirement of initial sensitizing exposure to the allergen. In non IgE mediated, the anaphylactoid reactions are close to those of true anaphylaxis, but do not require the IgE immune reaction. They are caused by direct stimulation. The same mediators that occur with true anaphylaxis are released and the same effects produced. This often happens on a first and repeated exposures since no sensitization is required.

The terms anaphylaxis and anaphylactoid (meaning "like anaphylaxis") are both used to describe severe allergic reaction. Anaphylaxis is used to describe IgE mediated and anaphylactoid is used to describe non IgE mediated reactions. The effects and reactions are generally the same and in general are treated in the same manner. It may appear that IgE mediated reactions occur upon first exposure but there has to have been a previous and probably unrealized sensitization.

You may not remember the uneventful sting or hidden allergen in food, but you will remember the anaphylactic reaction that occurs as subsequent response. Once you think you " ve had an anaphylactic reaction, you should see an allergist. The allergist will assess whether or not it was an allergic reaction or not. A detailed medical history along with skin and blood tests can identify the cause. Be prepared to recall events leading up to the incident such as the food and medications ingested and any contact with rubber products.

Common causes of IgE mediated anaphylaxis are medications, insect stings, foods, vaccines, hormones, latex, and animal and human proteins. Causes of non IgE mediated anaphylactic is medication, x-ray dye preservatives, physical conditions, and idiopathic. The management of anaphylaxis saves many lives. A high risk or affected person should be aware of possible triggers and early warning signs. One must keep an emergency kit available and try to avoid possible causes. If one is suspected of having an anaphylactic reaction, inject epinephrine immediately.

For insect stings, place a tourniquet between the puncture site and the heart. Loosen it every ten minutes for a few seconds. Place the conscious person lying down and elevate the feet if possible. If trained, begin CPR if the victim stops breathing or does not have a pulse. After ten to fifteen minutes, if the symptoms are still prevalent, you can inject another dose of epinephrine. Even after the reaction subsides, it is good to go to the emergency room or to an allergist for tests.

Other treatments after epinephrine include oxygen, intravenous fluids, breathing medications and possibly more epinephrine. A reaction that came about in the 1970's was (EIA) exercise induced anaphylaxis that occurs during prolonged, strenuous exercise. Conditioned athletes, such as marathon runners, are frequently affected. The reaction may occur while exercising shortly after a meal or after taking aspirin. Aspirin and food seem to load the gun and exercise pulls the trigger. Early symptoms are flushing and itching, which can progress to other symptoms typical of anaphylaxis if exercise continues.

Pre-medication does not seem to help EIA. Exercise avoidance is the only solution. Another situation in which no cause can be found for anaphylaxis is termed idiopathic. Recent reports that twenty-five percent of all anaphylaxis episodes are idiopathic. Many of those affected have underlying allergic or asthma conditions. For frequent episodes, the physician may recommend a combination antihistamine, cortisone, and a bronchial dilator to help widen the airways of the lungs.

Preventive measures are the ideal forms of treatment. It is not always easy since insect stings are frequently unanticipated and allergic food reactions are often hidden in a variety of preparations. A visit with an allergist is important in order to identify triggers and figuring the best way to avoid them. There are three situations that an allergist might be able to offer preventive treatment.

Allergy shots against insect stings may be suggested. This form of treatment gives ninety-eight percent protection against the first four insect reactions, although not as helpful against fire ants. Pre-medication is helpful in prevention anaphylaxis in x-ray dyes. Alternate dyes are available that can reduce the likelihood of a reaction. Desensitization to problem medications is also effective. This is accomplished by gradually increasing the amount of medication given under controlled conditions.

Sensitivities to penicillin, sulfa drugs, and insulin have been treated in this manner. Anyone known to be at risk for anaphylaxis should wear a medic alert bracelet that clearly states the allergens. The availability of an epinephrine kit should always be a priority. There are some basic ways to keep anaphylaxis from happening. For drugs and medication, one should let all health care personnel know of your allergies and any allergic reaction. Always ask your doctor if the prescribed medication contains the allergen you are allergic to.

You should also try to take all drugs by mouth instead of injections. In cases of insect stings, it is best to stay away from outside garbage areas, barbecues, and insect nests. It is also best to avoid bright colored clothing, heavy perfume, hair sprays, and lotions that may encourage or attract insects. When outdoors for prolonged periods of time, wear long sleeves, pants, and shoes at all times if possible.

With food, one should always carefully read all labels. When going out to eat, always ask the ingredients of any questionable dishes. Another good way to avoid reactions is to stay away from foods that cross react, such as bananas, kiwi, and avocados. Lastly, one should attempt to avoid all latex products. If being admitted into a hospital always ask it they have latex safety issues upon hospitalization. Since avoidance is not a perfect solution, a person at risk of an anaphylaxis reaction must always be prepared for an emergency situation.

It is highly recommended that any person with risk carry an emergency epinephrine kit designed for self-administration. These kits are available by prescription and come in two different forms. The most common form is the Epi-pen. It is a spring which loads automatically a syringe that delivers a specific amount when the tip is pressed hard for several seconds. The usual adult dose is 0.3 mg. The Epi-pen junior is used for children under 33 pounds.

It contains half the amount of an adult dose. The other kit is called the Ana-kit which contains a preloaded syringe and needles along with two adult doses of epinephrine. They are injected either under the skin or into the muscle of the thigh. An antihistamine alcohol swab and a tourniquet are also included with this kit. There are several important tips to remember about these type of kits. A person should first have a doctor carefully explain and demonstrate your type of prescribed kit.

Always keep a check on the expiration date and immediately replace if your kit is out of date. Keep kits out of direct sunlight which will break down the drugs. A person should also keep an extra kit available at school and work or any familiar place that you spend considerable amounts of time. Make sure that all of your friends, relatives, and co-workers are aware of your condition and know how to help in case of an allergic reaction. Once again, anaphylaxis is the most severe form of an allergic reaction and can possibly lead to death, especially if one is unprepared. The majority of people will never have an anaphylactic reaction.

The most common anaphylactic reactions are caused by drugs, insect stings, foods, x-ray dye, latex, and exercise. The most common symptoms may vary, but often include hives, tongue swelling, vomiting, and possible shock. The best form of treatment is to evade causes. If you are at high risk for anaphylactic reaction, always have an epinephrine kit at hand. It could possibly save your life.

Footnotes 1 PW. Ewan Clinical study nut allergies 1997 2 M. Fisher clinical observations 1986 3 AFT. Brown mechanisms and treatments.