Food Allergy & Anaphylaxis
Emergency Kit Contents
There are several medications that can be used to treat anaphylaxis. These include epinephrine, H1 antihistamines, H2 antihistamines, albuterol, and steroids. We recommend your emergency kit include the following:
Epinephrine: Epinephrine is the single most important drug in the anaphylaxis emergency kit. It will rapidly act to reverse any and all signs of anaphylaxis, but most importantly low blood pressure, poor heart rate, poor circulation, swelling, and asthma/bronchoconstriction. Epinephrine will also reverse skin and gastrointestinal symptoms.
H1 Antihistamines (e.g., Benadryl®): These medications block the effects of histamine released from the mast cell during an allergic reaction. This class of medication is particularly effective for skin symptoms and swelling that is not affecting the airways. This class of medication is not a good first choice for fainting, loss of consciousness, lethargy, difficulty breathing, low blood pressure, or poor circulation, but it can act as an important supporting medication to epinephrine.
H2 Antihistamine (e.g., Zantac®, Pepcid®, Tagamet®): These medications also block the effects of histamine but have a different target than their cousin, Benadryl. H2 antihistamines are particularly effective as a supporting medication, in particular when there are suspected cardiovascular symptoms, because they block the effects of histamine on the coronary arteries. They will also reduce abdominal discomfort from the histamine-triggered release of stomach acid.
Albuterol (if you have asthma): Albuterol rapidly reverses muscle constriction in the lungs that may contribute to wheezing, coughing, or shortness of breath. This should be administered right after epinephrine if respiratory symptoms are present.
A note on steroids in treating anaphylaxis: If you have gone to the emergency room for treatment of anaphylaxis, you likely have been given steroids. Steroids are very powerful anti-inflammatory drugs. However, steroids have little role in the acute management of anaphylaxis. It takes steroids up to 4-6 hours to begin working and therefore won’t help in the immediate treatment of anaphylaxis. However, they are important in preventing biphasic reactions as well as skin and respiratory symptoms. Steroids are often prescribed for up to three days after an anaphylactic reaction.
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