Anaphylactic Shock,Symptoms and Treatment
Anaphylactic shock is a sudden, severe allergic reaction usually characterized by a significant reduction in blood pressure, urticaria, and breathing complications that is caused by exposure to a foreign substance, such as a drug or bee venom, after an introductory or sensitizing exposure. The reaction can be dangerous if the patient is not attended to urgently with epinephrine injections. It is also commonly known as anaphylactic reaction or anaphylaxis. Anaphylactic reaction is the most dangerous of all the allergic reactions. It is a kind of reaction that involves the entire body system. A normal allergic reaction usually cause itching or probably some wheezing in the lungs but an anaphylactic reaction will cause both or a blend of several symptoms thus making it more deadly.
A wide range of triggers can bring about this form of reaction. Major causes of anaphylactic reaction can be clearly classified into three categories; food, drugs and venom. However, the relative importance of this varies greatly with age, with food being predominantly important in children and medical products affecting older people.
- 1. Drug allergies
Since anaphylaxis is a form of reaction, various people may have different reaction when they take some drugs. When these drugs are taken, they trigger the tissues in different parts of the body to produce a hormone called histamine. It is the effect of this histamine that culminates into anaphylactic reaction.
Drugs that have been known to cause this reaction include; antibiotics like penicillin, ciprofloxacin and cephalosporin; local anesthetics like suxamethonium and atracurium drugs prepared from animals, such as insulin, adrenocorticotropic hormone and enzymes; diagnostic agents, such as iodinated x-ray contrast media; biological used to provide immunity, such as vaccines, antitoxins and gamma globulin.
Some drugs like morphine, x-ray dye, and aspirin might cause an anaphylactic-like reaction (anaphylactoid reaction) when people are first exposed to them. Although these reactions are not the same as the immune system response that occurs with real anaphylaxis the signs, possibility of complications and medication are the same for both types of reaction.
- 2. Food allergies
Some food stuffs have been known to trigger anaphylactic shock. Among these nuts like peanuts, almond and walnut are the most common causes. Others include fish, grape, nectarine and strawberry.
- 3. Venom
This normally comes from stings of insects like bees and wasps. The venom in these stings is discovered as a foreign body making the body’s immune system to produce histamine as a defensive mechanism.
Anaphylactic and other diseases
There are a number of conditions that can increase the risk or severity of anaphylaxis. This include
- Asthma - Poorly controlled asthma has been interconnected to fatal anaphylaxis in adolescents and young adults.
- Cardiovascular diseases pose a great danger for anaphylaxis especially for elderly people.
- Mastocytosis - A disease that makes the body to overproduce mast cells (the cells that release histamine in an allergic reaction).
- Some medications may inhibit epinephrine. Persons at risk for anaphylaxis are advised to talk to their respective doctors about the supplementary medications they should take.
Symptoms of Anaphylaxis
Since this is originally an allergic reaction, for it to be identified then allergic symptoms need to be checked. These symptoms may vary from one individual to another depending on the level of exposure to the allergic substance and the body’s immune system reaction. The symptoms can develop quickly in minute or may be gradual. They include the following;
v Skin reactions
This allergic reaction is characterized by release of histamine as a defensive mechanism for the body. Histamine dilates the blood vessels resulting in itching, flaking and reddening of the skin. Sometime hives, which are reddish pink, can rise up causing swelling under the skin. Irritants like chemicals or detergents cause hives.
v Increased Gastric Secretions
Specialized cells in the stomach, called parietal cells, discharge hydrochloric acid. An increase in the level of hydrochloric acid leads to ulcers and irritation. Mast cells also exist in the lining of the stomach and contain H2 receptors. Histamine has an effect on parietal cells, combined with other enzymes, results in rising levels of gastric secretions.
v Breathing problems
Histamine produced during the reaction of the body to the allergic item causes the smooth muscle around the bronchi or airway passages in the lungs to contract thus constricting the flow of air. This results in breathing problems, which is associated with chest discomfort or tightness and wheezing. This is somehow evident in asthma victims.
As a result of the constriction of smooth intestinal muscles caused by histamine, there is an increase in peristalsis. This increased level of peristalsis can easily cause diarrhea.
v Abdominal pains
Histamine is released from inflammatory cells and binds to specific receptors in the membrane of intramuscular, free nerve endings (nociceptors). This makes the nociceptors to be excited which leads to pain in the muscles that support and move the skeleton.
Other common symptoms are abnormal heart rhythm, mental confusion, weaknesses, and difficulty in swallowing, vomiting and dizziness.
Treatment of Anaphylaxis
Epinephrine is considered an essential drug for the treatment of an anaphylactic reaction. An epinephrine auto-injector is a drug form of adrenaline, the fight-or-flight hormone that the body produces in emergencies. It increases heart rate and unlocks the airways and blood vessels enabling the patient to breathe better and allow efficient blood circulation. Epinephrine is a logical treatment and there is consistent reliable evidence supporting its use to ease breathing difficulty and restore adequate cardiac output. The patient is advised to lie down and stay horizontally after an admission of epinephrine.
Antihistamines also compliment epinephrine in the treatment for an anaphylactic reaction. Despite the evidence supporting their use being weak there are logical reasons for them.
Antihistamines counter histamine-induced vasodilation
and bronchoconstriction. They may not help in reactions depending in part on other
mediators but they have the virtue of safety. Used alone, they are unlikely to save lives
in a true anaphylactic reaction.
- Avoid triggers such as foods and medications that have caused an allergic reaction in the past. Always be inquisitive on the type of diet available in case you are eating away from home. Ingredients need to be studied before any preparation of meals.
- Parents with allergic children should introduce certain foods one at a time in small amounts to monitor the allergic reaction.
- Patients with serious allergic reactions to wear medical ID tags.
- Carrying of emergency medications like chewable form of diphenhydramine and injectable epinephrine