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Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis.
- Source :
-
The Journal of allergy and clinical immunology [J Allergy Clin Immunol] 2020 Apr; Vol. 145 (4), pp. 1082-1123. Date of Electronic Publication: 2020 Jan 28. - Publication Year :
- 2020
-
Abstract
- Anaphylaxis is an acute, potential life-threatening systemic allergic reaction that may have a wide range of clinical manifestations. Severe anaphylaxis and/or the need for repeated doses of epinephrine to treat anaphylaxis are risk factors for biphasic anaphylaxis. Antihistamines and/or glucocorticoids are not reliable interventions to prevent biphasic anaphylaxis, although evidence supports a role for antihistamine and/or glucocorticoid premedication in specific chemotherapy protocols and rush aeroallergen immunotherapy. Evidence is lacking to support the role of antihistamines and/or glucocorticoid routine premedication in patients receiving low- or iso-osmolar contrast material to prevent recurrent radiocontrast media anaphylaxis. Epinephrine is the first-line pharmacotherapy for uniphasic and/or biphasic anaphylaxis. After diagnosis and treatment of anaphylaxis, all patients should be kept under observation until symptoms have fully resolved. All patients with anaphylaxis should receive education on anaphylaxis and risk of recurrence, trigger avoidance, self-injectable epinephrine education, referral to an allergist, and be educated about thresholds for further care.<br /> (Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Evidence-Based Medicine
Humans
Hypersensitivity complications
Hypersensitivity therapy
Practice Guidelines as Topic
Risk Factors
Anaphylaxis prevention & control
Desensitization, Immunologic methods
Epinephrine therapeutic use
Glucocorticoids therapeutic use
Histamine Antagonists therapeutic use
Hypersensitivity diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6825
- Volume :
- 145
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of allergy and clinical immunology
- Publication Type :
- Academic Journal
- Accession number :
- 32001253
- Full Text :
- https://doi.org/10.1016/j.jaci.2020.01.017