Antihistaminic/steroid premedication does not prevent “anaphylactic shock” ?
If known to cause a previous reaction, avoid using that drug/agent.
After a moderate-severe anaphylactic rxn:
After a moderate-severe anaphylactic rxn:
Follow-up with blood (triptase), then skin test.
Skin test: skin prick, intradermal test (IgE) or
If there is a local or disseminated urticeria related to Chlorhexidin skin test is necessary.
Follow-up is not necessary:
Erhythema around the injection site, isolated bronchospasm in patients with previous bronchial reactivity.
Symptoms
Symptoms
Severity of the reaction
Onset time and length of the reaction,
Therapy
All the agents used before the reaction
Anesthesia form, notes
Fill the advers event form.
Serum triptase & IgE Ab.
Serum triptase & IgE Ab.
Blood sample for analysis must be drawn within 1-4 hrs following the rxn. 5-10 mL blood, serum. The timing of the blood sampling after the reaction should be noted ?
Control blood sample should be drawn before Anaphylaxis or 24 hrs after the reaction.
Blood for IgE analysis can be sampled within 6 months after the reaction.
Skin test:
Skin test:
Evaluates mast cell rxn by IgE. Salin (-) control, Histamin (+) control. Test has to be done 6 weeks after the reaction.
Bir NMBA ile (+) sonuç alındıysa, diğer NMB test edilmeli.
Bir LA rxn varsa diğerleri test edilmeli. Cross reactivity.
Drug provacation test: RISKY !
It has to be performed after the skin test.
Generally 1/10 of the therapeutic dose of the drug responsible for the reaction is given via same route.
