Anaphylaxis is a severe allergic reaction that needs to be treated right away. If you have an anaphylactic reaction, you need an epinephrine (adrenaline) shot as soon as possible, and someone should call 911 for emergency medical help. Left untreated, it can be deadly.
Thomas Chacko, MD Allergist
Epinephrine can reverse the symptoms within minutes. If this doesn't happen, you may need a second shot within half an hour. These shots, which you need a prescription to get, come pre-filled and in ready-to-use pens.
You shouldn’t take an antihistamine for an anaphylactic reaction.
Anaphylaxis is rare, and most people recover from it. But it's important to tell your doctor about any drug allergies you have before any kind of medical treatment, including dental care. It’s also a good idea to wear a medical alert bracelet or pendant or carry a card with information about your allergy.
If you've had an anaphylactic reaction before, you have a higher risk of having another one. You also have a higher risk if you have a family history of anaphylaxis or have asthma.
There is usually more than one of these:
- Coughing; wheezing; and pain, itching, or tightness in your chest
- Fainting, dizziness, confusion, or weakness
- Hives; a rash; and itchy, swollen, or red skin
- Runny or stuffy nose and sneezing
- Shortness of breath or trouble breathing and rapid heartbeat
- Swollen or itchy lips or tongue
- Swollen or itchy throat, hoarse voice, trouble swallowing, tightness in your throat
- Vomiting, diarrhea, or cramps
- Weak pulse, paleness
Some people also remember feeling a "sense of doom” right before the attack.
As many as 1 out of every 5 people may have a second anaphylactic reaction within 12 hours of the first. This is called a biphasic anaphylaxis.
Epinephrine is the most effective treatment for anaphylaxis, and the shot should be given right away (usually in the thigh). If you’ve had an anaphylaxis reaction before, you should carry at least two doses of epinephrine with you at all times.
Epinephrine expires after about a year, so make sure your prescription is up to date. If you have an anaphylactic reaction and the pen has expired, take the shot anyway.
When medical personnel arrive, they may give you more epinephrine. If you’re not able to breathe, they may put a tube down your mouth or nose to help. If this doesn’t work, they might do a kind of surgery called a tracheostomy that puts the tube directly into your windpipe.
You probably will need to stay in the emergency room for several hours to make sure you don't have a second reaction.
After the initial emergency is over, see an allergy specialist, especially if you don't know what caused the reaction.
Anaphylaxis happens when you have an antibody, something that usually fights infection, that overreacts to something harmless like food. It might not happen the first time you come in contact with the trigger, but it can develop over time.
In children, the most common cause is food. For adults, the main cause is medication.
Typical food triggers for children are:
Common food triggers for adults are:
- Tree nuts (walnuts, hazel nuts, cashews, pistachios, pine nuts, and almonds)
Some people are so sensitive that even the smell of the food can trigger a reaction. Some are also allergic to certain preservatives in food.
Common medication triggers are:
- Penicillin (more often following a shot rather than a pill)
- Muscle relaxants like the ones used for anesthesia
- Aspirin, ibuprofen, and other NSAIDs (non-steroidal anti-inflammatory drugs)
- Anti-seizure medications
Anaphylaxis also can be triggered by a few other things. But these aren’t as common:
Some people can have an anaphylactic reaction if they breathe in latex.
Some can have a reaction to a combination of things:
- Breathe in birch pollen and eat apple, raw potato, carrots, celery, or hazelnut
- Breathe in mugwort pollen and eat celery, apples, peanuts, or kiwi
- Breathe in ragweed pollen and eat melons or bananas
- Touch latex and eat papaya, chestnuts, or kiwi
Anaphylactic reactions usually start within minutes of contact with the trigger, but they can also happen an hour or more later.
Some people never figure out what caused their reactions.