Case Study Anaphylaxi
Alterations in Immunity Case Study 1. Explain the process of anaphylaxis. Could shellfish be the only cause for Mr. Smith’s reaction? Anaphylaxis occurs when a hypersensitivity reaction is extremely severe. It happens within minutes of the reexposure to the antigen. In this case it would be considered systemic anaphylaxis. Unless treated quickly it can result in death. Mr. Smith presented with anaphylaxis symptoms that occurred within minutes of exposure to the allergen and included abdominal cramps and constriction of airway. Mr. Smith is fully aware of his allergies thus he made sure the casserole did not contain shellfish, unfortunately it did and the result was people getting sick. 2. What about the others who became ill? How would you determine that this casserole
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would be the cause of everyone’s distress or not?
Its obvious that the other people in the picnic who ate the casserole have experienced a mild allergic food reaction. For some people, an allergic reaction to a particular food may be uncomfortable but not severe. For other people, an allergic food reaction can be frightening and even lifethreatening like Mr. Smith because it compromised his breathing. Food allergy symptoms usually develop within a few minutes to two hours after eating the offending food.
The only way to avoid an allergic reaction is to avoid the foods that cause signs and symptoms.
However, despite best efforts, the people in the picnic came into contact with a food that caused a reaction.
For a minor allergic reaction
, overthecounter or prescribed antihistamines may help reduce symptoms. These drugs can be taken after exposure to an allergycausing food. However, antihistamines can 't treat a severe allergic reaction.
3. What pharmacological intervention might Mr. Smith expect (what drugs might be given initially and then prescribed on an outpatient basis)?
Anaphylaxis is a severe, acute and potentially lifethreatening condition, often in response to an allergen. Patients experiencing anaphylaxis can present with cutaneous, respiratory, cardiovascular or gastrointestinal manifestations. Epinephrine given intramuscularly remains the mainstay of treatment for this condition. Other secondline therapies, such as inhaled beta2 agonists, H1 and H2 receptor antagonists and corticosteroids, may play a role in resolving respiratory and cutaneous signs and symptoms. Biphasic reactions may occur during the resolution phase of symptoms and, thus, all patients should be observed for a minimum of 4 h to
6 h before discharge from hospital. On discharge, all patients should be prescribed epinephrine autoinjectors, and referred to an allergist or immunologist for further evaluation and education.
Outpatient medications are the oral forms of antihistamines and corticosteroids that should be continued for a short time (a few days) following an episode. 4. What about the others who had a reaction to this casserole?
Avoiding the offending allergen in the diet is the primary treatment of food allergy. Once a food to which the patient is sensitive has been identified, the food must be removed from the diet.
Several medications are available for treating the other symptoms of food allergy. For example, antihistamines can relieve gastrointestinal symptoms
5. What instructions/education would you give to Mr. Smith to help prevent any future episodes (what should he change, avoid, etc.)? What about the others who didn’t have as severe symptoms as Mr. Smith?
A person with allergies, as well as his or her family, close friends, teachers, and coworkers, should learn to use an epinephrine autoinjector before it is needed. Anaphylaxis is unpredictable, and while a person may have a mild reaction one time, a serious or even lifethreatening reaction can occur the next time.
A person suffering with anaphylaxis may panic and be unable to assist with his/her own injection. In addition, a quick response is necessary to prevent serious complications of anaphylaxis.
An epinephrine autoinjector prescription should be filled immediately. Anyone who is at risk of anaphylaxis should keep at least one epinephrine autoinjector with them at all times.
Epinephrine is the best treatment for anaphylaxis and it works best if it is given within the first few minutes of a severe allergic reaction. Epinephrine rapidly treats all of the most dangerous symptoms of anaphylaxis, including throat swelling, difficulty breathing, and low blood
pressure. However, epinephrine is not a perfect treatment, so allergic triggers should be avoided. people who have had anaphylactic reactions to a food should wear medical alert bracelets or necklaces stating that they have a food allergy and that they are subject to severe reactions. 6. Could there be any individual differences in Mr. Smith and the others that could influence how they reacted to medications given for this
situation?
Everyone reacts to medications differently. One person may develop a rash while taking a certain medication, while another person on the same drug may have no adverse reaction. Does that mean the person with the rash has an allergy to that drug?
All medications have the potential to cause side effects, but only about 5 to 10% of adverse reactions to drugs are allergic.
Whether allergic or not, reactions to medications can range from mild to lifethreatening.
Sometimes the treatment is worse than the condition itself! That’s what happens when people with allergies are allergic to the medication they take to relieve their symptoms, and sometimes the reaction can be life threatening. References: Anaphylaxis: MedlinePlus Medical Encyclopedia. (2014, May 1). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000844.htm Allergic Reaction: Click for Symptoms and Treatment. (2015). Retrieved from
http://www.emedicinehealth.com/allergic_reaction/article_em.htm
would be the cause of everyone’s distress or not?
Its obvious that the other people in the picnic who ate the casserole have experienced a mild allergic food reaction. For some people, an allergic reaction to a particular food may be uncomfortable but not severe. For other people, an allergic food reaction can be frightening and even lifethreatening like Mr. Smith because it compromised his breathing. Food allergy symptoms usually develop within a few minutes to two hours after eating the offending food.
The only way to avoid an allergic reaction is to avoid the foods that cause signs and symptoms.
However, despite best efforts, the people in the picnic came into contact with a food that caused a reaction.
For a minor allergic reaction
, overthecounter or prescribed antihistamines may help reduce symptoms. These drugs can be taken after exposure to an allergycausing food. However, antihistamines can 't treat a severe allergic reaction.
3. What pharmacological intervention might Mr. Smith expect (what drugs might be given initially and then prescribed on an outpatient basis)?
Anaphylaxis is a severe, acute and potentially lifethreatening condition, often in response to an allergen. Patients experiencing anaphylaxis can present with cutaneous, respiratory, cardiovascular or gastrointestinal manifestations. Epinephrine given intramuscularly remains the mainstay of treatment for this condition. Other secondline therapies, such as inhaled beta2 agonists, H1 and H2 receptor antagonists and corticosteroids, may play a role in resolving respiratory and cutaneous signs and symptoms. Biphasic reactions may occur during the resolution phase of symptoms and, thus, all patients should be observed for a minimum of 4 h to
6 h before discharge from hospital. On discharge, all patients should be prescribed epinephrine autoinjectors, and referred to an allergist or immunologist for further evaluation and education.
Outpatient medications are the oral forms of antihistamines and corticosteroids that should be continued for a short time (a few days) following an episode. 4. What about the others who had a reaction to this casserole?
Avoiding the offending allergen in the diet is the primary treatment of food allergy. Once a food to which the patient is sensitive has been identified, the food must be removed from the diet.
Several medications are available for treating the other symptoms of food allergy. For example, antihistamines can relieve gastrointestinal symptoms
5. What instructions/education would you give to Mr. Smith to help prevent any future episodes (what should he change, avoid, etc.)? What about the others who didn’t have as severe symptoms as Mr. Smith?
A person with allergies, as well as his or her family, close friends, teachers, and coworkers, should learn to use an epinephrine autoinjector before it is needed. Anaphylaxis is unpredictable, and while a person may have a mild reaction one time, a serious or even lifethreatening reaction can occur the next time.
A person suffering with anaphylaxis may panic and be unable to assist with his/her own injection. In addition, a quick response is necessary to prevent serious complications of anaphylaxis.
An epinephrine autoinjector prescription should be filled immediately. Anyone who is at risk of anaphylaxis should keep at least one epinephrine autoinjector with them at all times.
Epinephrine is the best treatment for anaphylaxis and it works best if it is given within the first few minutes of a severe allergic reaction. Epinephrine rapidly treats all of the most dangerous symptoms of anaphylaxis, including throat swelling, difficulty breathing, and low blood
pressure. However, epinephrine is not a perfect treatment, so allergic triggers should be avoided. people who have had anaphylactic reactions to a food should wear medical alert bracelets or necklaces stating that they have a food allergy and that they are subject to severe reactions. 6. Could there be any individual differences in Mr. Smith and the others that could influence how they reacted to medications given for this
situation?
Everyone reacts to medications differently. One person may develop a rash while taking a certain medication, while another person on the same drug may have no adverse reaction. Does that mean the person with the rash has an allergy to that drug?
All medications have the potential to cause side effects, but only about 5 to 10% of adverse reactions to drugs are allergic.
Whether allergic or not, reactions to medications can range from mild to lifethreatening.
Sometimes the treatment is worse than the condition itself! That’s what happens when people with allergies are allergic to the medication they take to relieve their symptoms, and sometimes the reaction can be life threatening. References: Anaphylaxis: MedlinePlus Medical Encyclopedia. (2014, May 1). Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000844.htm Allergic Reaction: Click for Symptoms and Treatment. (2015). Retrieved from
http://www.emedicinehealth.com/allergic_reaction/article_em.htm