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of people who take NSAIDs ( Nzeako 2010 ). These chemicals can recruit other cells, like eosinophils, and may lead to anaphylaxis. This can cause an abundance of leukotrienes and other pro-inflammatory mediators and precipitate angioedema ( Nzeako 2010 ). Pro-inflammatory mediators then act on the mucosa and cause angioedema.
Despite being highly effective in treating acute allergic reactions, first-generation H1 antihistamines cross the blood-brain barrier and bind to H1 receptors, which can lead to undesirable side effects, including drowsiness, sedation, fatigue, and decreased cognition (Church MK 2010). 2010 Apr;65(4):459-66. Epub 2010 Feb 8.
AnaphylaxisAnaphylaxis may present as hypotension alone. Thus, it may easily be confused with a different form of shock and treated with vasopressors such as norepinephrine and vasopressin, which are not first line for anaphylaxis. 2010; 36: 2019-2029. Urticaria should prompt consideration of anaphylaxis.
The patient is agitated on a backboard with C-collar in place. BMC Pharmacol Toxicol. May 2; 19(1): 19. Schulman, S et al. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in surgical patients. J Thromb Haemost. Jan; 8(1): 202-4. Samuelson, B.T., Jan; 151(1): 127-138.
Source control timely antibiotics, rational fluid resuscitation, and ruling out other causes of vasopressor refractory shock to include anaphylaxis, hemorrhage, adrenal insufficiency, LVOT obstruction, and any other cause of cardiogenic shock need to be ruled out and addressed. NEJM 2008; 358(9): 877 – 87. PMID: 18305265 Celi A et al.
massive bee envenomation - R4 Capstone - Hydrocephalus - cpc: brain tumor - hyperviscosity syndromes - the language of being well & embracing fear in emergency medicine tamingthesru: Massive bee envenomation WITH dr. Yates Anaphylaxis Pathophysiology Type 1 Hypersensitivity Reaction IgE-mediated Mast-cell degranulation of vasoactive materials Reaction (..)
We know that if administered too rapidly, it can lead to hypotension and other adverse effects including seizures, headaches, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, pulmonary embolism, deep vein thrombosis, anaphylaxis, impaired color vision, and other visual disturbances.[1] Lancet 2010; 376:23-32.[
Jeff: Hypotension should be treated with isotonic fluids and, as usual, anaphylaxis should be treated with the usual cocktail of antihistamines and epinephrine at first IM and then via infusion if refractory. Note that antivenom will NOT reverse anaphylaxis on its own. Regardless, the treatment is the same – epinephrine. Cumpston KL.
Read More: Infectious Disease Society of America 2010 Clinical Practice Guidelines Life in the Fast Lane: Febrile Neutropaenia Uptodate: overview of neutropenic fever syndromes EMRAP: Risk stratification of neutropenic fever MDCalc: MASCC Score MDCalc: CISNE Score References: Ahn S, Rice TW, Yeung SJ, Cooksley T. Sepkowitz, K. Boeckh, M.
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