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The Allergic Patient

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Pharmacological Basis of Acute Care

Abstract

Allergy refers to an exaggerated response by our immune system to exposure to certain allergens which are normally harmless. Allergy manifestations can range from mild symptoms to a life-threatening event related to anaphylaxis, also known as a type 1 hypersensitivity reaction. The cornerstone of management is strict avoidance of known allergens, prompt diagnosis and pharmacological treatment to counteract the actions of allergy mediators. Adrenaline is the recommended first-line treatment in anaphylaxis. Second-line pharmacological agents include H1-antihistamines, corticosteroids, beta 2-agonists and vasopressors. In severe anaphylaxis, support of the cardiovascular system with oxygen and fluids as well as adrenaline may be necessary. Failure to relieve bronchospasm by pharmacological means may require mechanical ventilation to maintain effective oxygenation.

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Further Reading

  1. Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(6 Suppl):S1–58.

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  2. Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, Bernstein DI, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol. 2010;126(3):477–80, e1–42.

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  3. Schwartz LB. Systemic anaphylaxis, food allergy, and insect sting allergy. In: Goldman L, Schafer AI, editors. Cecil Medicine. 24th ed. Philadelphia: Saunders Elsevier; 2011.

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  4. Simons FE, Ardusso LR, Bilo MB, El-Gamal YM, Ledford DK, Ring J, et al. World Allergy Organization anaphylaxis guidelines: summary. J Allergy Clin Immunol. 2011;127(3):587–93, e1–22.

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Correspondence to Sook Hui Chaw M.D., M.Anaes .

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© 2015 Springer International Publishing Switzerland

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Chaw, S.H., Chow, K.Y. (2015). The Allergic Patient. In: Chan, Y., Ng, K., Sim, D. (eds) Pharmacological Basis of Acute Care. Springer, Cham. https://doi.org/10.1007/978-3-319-10386-0_26

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  • DOI: https://doi.org/10.1007/978-3-319-10386-0_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-10385-3

  • Online ISBN: 978-3-319-10386-0

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