Identifying Patients at Risk for an Anaphylactic Reaction
Risk factors for an anaphylactic reaction include a previous emergency room visit for a significant allergic reaction, rapid progression/progressively systemic reactions to repeat exposure, or not seeing a physician about a prior mild or significant allergic reaction.1 However, identifying patient-specific risk factors goes beyond a history of anaphylaxis, as the severity of previous reactions is not always indicative of the severity of future reactions.2
There are factors that increase the risk of anaphylaxis such as exposure to certain allergens for those who are allergic and age, as well as factors which may increase the risk of a severe or fatal anaphylactic reaction such as concomitant diseases and medications which hinder a patient from recognizing the signs and symptoms of anaphylaxis.3 A complete description of these risk factors is described in Tables 1 and 2.
|TABLE 1. Factors that increase the risk of experiencing anaphylaxis|
Exposure to certain allergens increases the risk of triggering an anaphylactic reaction for those who are allergic, and include4
|Table 2. Factors that may increase anaphylaxis severity or risk of fatality|
The following concomitant diseases are associated with an increased risk of a severe or fatal anaphylactic reaction.3
In patients of any age, concomitant diseases hampering recognition of signs and symptoms of anaphylaxis may place patients at an increased risk of a more severe anaphylactic reaction.3 Such diseases include
Concurrent medication or chemical use
In patients of any age, concurrent medications and chemicals hampering recognition of signs and symptoms of anaphylaxis may place patients at an increased risk of anaphylaxis.3 Such medications and/or chemicals include:
Medications that may increase the severity of anaphylactic reactions and make them more difficult to treat include3
EpiPen® (epinephrine) 0.3 mg and EpiPen Jr® (epinephrine) 0.15 mg Auto-Injectors are indicated in the emergency treatment of type 1 allergic reactions, including anaphylaxis, to allergens, idiopathic and exercise-induced anaphylaxis, and in patients with a history or increased risk of anaphylactic reactions. Selection of the appropriate dosage strength is determined according to body weight.
EpiPen Auto-Injectors should only be injected into the anterolateral aspect of the thigh. DO NOT INJECT INTO BUTTOCK, OR INTRAVENOUSLY.
Epinephrine should be used with caution in patients with certain heart diseases, and in patients who are on drugs that may sensitize the heart to arrhythmias, because it may precipitate or aggravate angina pectoris and produce ventricular arrhythmias. Arrhythmias, including fatal ventricular fibrillation, have been reported in patients with underlying cardiac disease or taking cardiac glycosides or diuretics. Patients with certain medical conditions or who take certain medications for allergies, depression, thyroid disorders, diabetes, and hypertension, may be at greater risk for adverse reactions. Other adverse reactions include transient moderate anxiety, apprehensiveness, restlessness, tremor, weakness, dizziness, sweating, palpitations, pallor, nausea and vomiting, headache, and/or respiratory difficulties.
EpiPen and EpiPen Jr Auto-Injectors are intended for immediate self-administration as emergency supportive therapy only and are not intended as a substitute for immediate medical or hospital care.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
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