Severe Allergic Reaction (Anaphylactic Shock) (cont.)
What Are Medical Treatments for a Severe Allergic Reaction?
The first priority in the emergency department is to protect the airway (breathing) and maintain adequate blood pressure.
The emergency team will make sure that your airway is open and that you are getting adequate oxygen.
- Oxygen may be given through tubes into the nose or by face mask.
- In severe respiratory distress, mechanical ventilation may be required. In this situation, a tube is placed via the mouth into the air passages to keep the airway open. The tube is connected to a ventilator (providing oxygen directly into the lung).
- In rare cases when the swelling prevents placing an airway through the mouth, a surgery is performed to open an airway (tracheostomy).
If blood pressure is dangerously low, medication to increase blood pressure will be given.
- An intravenous (IV) catheter will be inserted.
- This is used to give saline solution to help boost blood pressure.
- The IV line may also be used to give medication to combat the reaction, as well as medications to stabilize blood pressure.
You may need to be admitted to the hospital for further monitoring and treatment.
What Medications Treat Severe Allergic Reactions?
- Epinephrine: Given in severe allergic reactions, epinephrine is extremely effective and fast-acting; it acts by constricting blood vessels, which increases blood pressure, and widening the airway. Epinephrine is given by injection into the muscle, through an IV line, or by injection under the skin.
- H1-receptor blockers/antihistamines: Usually diphenhydramine (Benadryl); these drugs do not stop the reaction but relieve some of the symptoms. They may be given by IV, by injection in the muscle, or by mouth
- Inhaled beta-agonists (albuterol): Used to treat bronchospasm (spasms in the lung) and dilate the airways; inhaled
- H2-receptor blockers: Usually ranitidine (Zantac); given by IV or by mouth
- Corticosteroids (examples are prednisone, Solu-Medrol): These drugs help decrease the severity and recurrence of symptoms; may be given orally, injected in muscle, or by IV line
- If low blood pressure does not improve, additional medications, such as dopamine, may be given.
Medically Reviewed by a Doctor on 10/11/2017
Jerry R. Balentine, DO, FACEP
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