Bendaryl vs. Epi ... help!

[CMdeux]

Yes, it's a really top-notch review article.  VERY detailed and thorough examination of what current is (and is not) known about the allergic cascade and relevant pharmacology.   

[Janelle205]

You know, if someone actually was having to epi themselves or their child once a week, as you suggest, they likely really need to review their management practices.


Upon further reflection, I said that I wouldn't epi for just a rash.  That's not necessarily true.  If I had a rash and found out that I had somehow consumed something with apple in it, I would go ahead and epi, no waiting, no questions asked.  But that is my plan (approved by a board certified allergist), and if I've come into contact with something with apples, I've played this game enough times to know where it is going.

[twinturbo]

Everything You Wanted to Know About Epinephrine and More 
Wednesday, February 26, 2014 at 7pm Eastern (4pm Pacific)

Register: https://www4.gotomeeting.com/register/170327023



Angela Nace, PharmD, author of our very popular Epinephrine Comparison blog post, and Michael Pistiner, MD, MMSc, Chair of KFA's Medical Advisory Team and frequent guest speaker on our webinar series, will answer your questions about epinephrine.  Submit your questions in advance on the registration.  We thank Mylan Specialty for sponsoring this event.

[LinksEtc]

"Safety of epinephrine for anaphylaxis in the emergency setting"
http://www.wjem.org/upload/admin/201311/d095a4afd3dc3f7fc3baa8d33a54d10b.pdf

Why not antihistamines or corticosteroids first?

There is no evidence that they provide life-saving treatment (i.e. they do not prevent or relieve upper airway obstruction, hypotension, or shock).[24] Antihistamines [IM or intravenous (IV)] are adjunctive therapies and may be tried after epinephrine is administered to help control cutaneous and cardiovascular manifestations, such as itching, flushing, urticaria, angioedema, and nasal and eye symptoms, as well as prevent secondary reactions.

[twinturbo]

I'm tinkering with getting my EMT basic this summer. This'll come in handy during "that" portion. I should ask Silver how her son handled it, continues to handle it in the field.

[LinksEtc]

Tweeted by @Allergy

-----------------------------

"Anaphylaxis treatment: current barriers to adrenaline auto-injector use"

http://onlinelibrary.wiley.com/doi/10.1111/all.12387/full?utm_content=bufferb6b2b&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

Limited awareness of the treatment of anaphylaxis by health professionals

Data from several cohort studies illustrate the extent of under-treatment of anaphylaxis and the low rate of adrenaline use [12, 15, 39-41], with most cases of anaphylaxis that require hospitalization not receiving an AAI on discharge. Adrenaline is much less commonly used than antihistamines and corticosteroids in treating anaphylaxis despite both antihistamines [42] and corticosteroids [43, 44] having an onset of action that is delayed and too late to prevent respiratory and/or cardiovascular arrest, which can occur within minutes [23].

[candyguru]

This is the procedure we have followed in the past.

Siena (age 5 at the time) ate a product with lentils.  She did not feel well (we did not know of her lentil allergy at that time).  Called 911.  She felt weak and had a stomach ache and was lying down and had a cough.  We gave her epi-pen.  No hives. Firefighters arrived in about 4 minutes.. 2 mins later, ambulance arrived - took her to North York General Hospital.

Upon arrival the doctors gave her epi-pen #2 (about 15 mins after epi-pen 1).  They hooked her up to an IV and gave her steroids and benedryl.... kept the IV attached for 5 hrs.  After being discharged, she received steroid prescription for following 3 days.

There were no hives until after we arrived at the hospital, when only a few small ones appeared.  But even in the absence of hives, we knew right away she needed the epi-pen, and when we got to the hospital the E/R doctor knew she needed a second epi-pen. (actually, epi-pen jr)

After dealing with allergies all these years, we are probably the best ones to know if she needs an epi-pen. An EMT would not see any hives and may not even think it is necessary but we know our daughter and her allergic history of reactions to various allergens.

[ajasfolks2]

Saw this quote on Facebook.  Supposedly attributable to Dr. Wallace from "recent" anaphylaxis conference.

Speaking about the role of antihistamines in anaphylaxis:

"Antihistamines are what you give to reduce itching and hives while you watch the patient die of anaphylaxis."

[CMdeux]

{snort}



EXACTLY.

[LinksEtc]

Tweeted by @AllergicLiving

"Allergist Talks About Anaphylaxis (Severe Allergic Reactions)"
https://m.youtube.com/watch?v=184oft9bW0s&feature=youtu.be

Antihistamines will never ever ever stop a severe anaphylaxis reaction from progressing. The right thing to do is, as early as possible with one of these episodes, is to use your epinephrine auto-injector

[Mfamom]

Great Line