Preventing anaphylaxis is the ideal form of treatment. However, that may not always be easy since insect stings are frequently unanticipated and allergic foods are often hidden in a variety of different preparations. A consultation with an allergist is vital in helping you identify the trigger(s) and providing you with information and instruction on how to best avoid them. You will learn how to use emergency kits and how to become prepared for any reaction in the future.
These are three situations in which preventive treatment might be offered by the allergist.
- Allergy shots may be suggested to some people with wasp, yellow jacket, hornet, honey bee, or fire ant reactions. This form of treatment gives 98% protection against the first four insect reactions, though somewhat less protection against fire ant reactions.
- Pre-medication is most helpful in preventing anaphylaxis from x-ray dyes. Alternative dyes that are less likely to cause reactions may be available.
- Desensitization to problematic medications is often effective. This process is accomplished by gradually increasing the amount of the medication given under controlled conditions. Sensitivities to penicillin, sulfa drugs, and insulin have been successfully treated in this way.
Anyone known to be at risk for anaphylaxis should wear a Medic-Alert bracelet that clearly states the allergic trigger, the risk of anaphylaxis, and the availability of an epinephrine kit.
People with anaphylaxis to medications should take new medications by mouth whenever possible since the risk of anaphylaxis is higher with injections.
Since avoidance is not fail safe, a person at risk for an anaphylactic reaction must be adequately prepared in an emergency to handle a reaction. It is recommended that everyone at risk carry epinephrine injection kits designed for self-administration. These kits are available by prescription only and come in two forms:
- Epi-pen is a spring-loaded automatic syringe that delivers a predetermined dose (0.3mg) when the tip is pressed hard for several seconds. An Epi-pen junior is available for children under 33 pounds and contains half of the dose.
- Ana-kit contains a preloaded syringe and needles with two 0.3mg doses of epinephrine. These are injected under the skin or into the muscle of the thigh. An antihistamine, alcohol swab, and a tourniquet are included in the kit.
Here are some important points to remember regarding the kits:
- Ask you doctor to explain the use of the kit carefully and practice with the demonstrator kit.
- Check expiration dates and replace outdated kits.
- Keep kits out of direct sunlight, which may effect the drug.
- Additional kits should be brought to school or work.
- Always have kits with you or readily available.
- Make sure that your friends, relatives, exercise buddies, and co-workers are aware of your condition and know what to do in case of a reaction.
Anaphylaxis At A Glance
- Anaphylaxis is the most severe allergic reaction and is potentially life threatening.
- Anaphylaxis is rare. The vast majority of people will never have an anaphylactic reaction.
- The most common causes of anaphylaxis include drugs, such as penicillin, insect stings, foods, x-ray dye, latex, and exercise.
- The symptoms of anaphylaxis may vary from hives, tongue swelling, and vomiting, to shock.
- If you are at risk, avoidance is the best form of treatment.
- If you have a history of serious allergic reaction, always have an epinephrine kit available - it could save your life.
Revision date: July 3, 2011
Last revised: by Janet A. Staessen, MD, PhD