life-threatening condition that can develop at any age. a severe IgE-mediated type I hypersensitivity reaction,
Risk factors for anaphylaxis include immune disorders such as asthma and mast cell disorders.
| Triggers | • Food (eg, nuts, shellfish) • Medications (eg, β-lactam antibiotics) • Insect stings | | --- | --- | | Clinical manifestations | • Cardiovascular ◦ Vasodilation → hypotension & tissue edema ◦ Tachycardia • Respiratory ◦ Upper airway edema → stridor & hoarseness ◦ Bronchospasm → wheezing • Cutaneous ◦ Urticarial rash, pruritus, flushing • Gastrointestinal ◦ Nausea, vomiting, abdominal pain | | Treatment | • Intramuscular epinephrine • Airway management & volume resuscitation • Adjunct therapy (eg, antihistamines, glucocorticoids) |
The widespread release of chemical mediators from mast cell degranulation results in the multisystem, broad-ranging symptoms of anaphylaxis.
Patients with underlying pulmonary or cardiovascular comorbidities are at increased risk for poor outcomes.
Medications such as NSAIDs or beta blockers can exacerbate anaphylaxis by resulting in nonimmunologic mast cell activation or unopposed alpha-adrenergic effects, respectively.
(Choice F) Intravenous fluids (eg, normal saline) can help treat anaphylaxis-induced hypotension, a type of distributive shock caused by profound peripheral vasodilation and increased vascular permeability. This patient's blood pressure is normal for his age; therefore, epinephrine administration is a better first step to prevent hypotension from developing.