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In the emergency setting anaphylaxis is a dangerous life threatening condition that must be treated in an aggressive and timely fashion Anaphylaxis is a condition related to acute allergic reactions Following the bodys exposure to the offending allergen there are common systemic reactions The most serious reactions involve the respiratory and cardiovascular systems but the gastrointestinal dermatologic and genitourinary systems are often involved causing varied symptoms such as urticaria flushing angioedema bronchospasm hypotension cardiac arrythmias nausea intestinal cramps pruritus and finally uterine cramps Physician Assistant 894 The above list is by no means exhaustive specific symptoms vary from person to person The same person suffering from several anaphylactic reactions can also present with differing symptoms Physiologically speaking the two main effects of the bodys released mediators IgE during an anaphylactic reaction are smooth muscle contraction and vasodilatation which cause most of the bodys adverse symptoms JAMA 112682 Since the most life threatening reactions usually involve the respiratory and cardiovascular systems that is where emergency treatment is focused In the cardiovascular system a combination of vasodilatation increased vascular permeability tachcycardia and arrhythmias can lead to severe hypotension In the respiratory system the swelling of tissues along with bronchospasm and increased mucus production are the main cause of death So if untreated anaphylaxis can be fatal as a result of the bodys going into what is essentially shock while simultaneously and more importantly being deprived of the oxygen needed to sustain life As of today there is one universally accepted treatment for acute anaphylaxis Epinephrine Epinephrine is both an alpha and a beta agonist This makes it the drug optimally suited to treat anaphylaxis Epinephrine will increase vascular resistance reduce vascular permeability produce bronchodilation and increase cardiac output Emergency 1093 Epinephrine will directly counteract the potentially life threatening aspects of anaphylaxis Epinephrine can and is used in the both the pre-hospital environment as well as in definitive care institutions Epinephrine is widely administered by ALS providers
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