Summary and conclusions Anaphylaxis is a potentially fatal condition. Causes range from bee stings to drugs, foods, and exercise. Onset is usually sudden, and a delayed reaction may occur hours after the initial reaction. Treatment consists of airway maintenance and support of the blood pressure with fluid expanders, epinephrine, and oxygen. Additional agents, such as corticosteroids, antihistamines, vasopressors, glucagon, atropine sulfate, and isoproterenol hydrochloride, can be useful.
Prevention is the most important part of anaphylaxis management.
In patients with known allergies, self-administration of epinephrine plays a key role in reducing mortality. The kit or syringe should be readily available at all times. Exposure to air and light can cause the epinephrine to oxidize and turn brown, at which point the syringe should be replaced. Epinephrine for emergency self-administration is available in several forms. The syringe has a 25-gauge needle and is operated manually, so there is little chance of accidental injection.