Anaphylaxis Prevention

By Dr Ananya Mandal, MD

Persons who have experienced anaphylaxis once are likely to suffer from it again when exposed to triggers. Several measures may be adopted to prevent anaphylaxis or treat them urgently.

Some of the measures include:-

  • Avoidance of triggers

    While all triggers that cause anaphylaxis are impossible to avoid, some may be easily and safely be avoided.

    For example, those who have had an anaphylactic shock attack due to some food allergies need to avoid that food. Basic steps include checking the labels of foods thoroughly before consumption, informing hosts or staff at a restaurant about the food allergy before preparation etc.

    Some foods may have small traces of the allergenic foods. For example some sauces and gravies may include small amounts of peanuts that a person may be allergic to. One who is susceptible needs to be aware.

    Insect stings are one of the triggers of anaphylaxis that are difficult to avoid. Some of the basic precautions include moving away calmly from bees, hornets and wasps without panicking or trying to swat them.

    Wearing long sleeved shirts and trousers, shoes and socks while outdoors and avoiding bright colours and strong perfumes or cosmetics helps in avoiding insect bites to a certain extent. Insect repellents may also help ward off insects.

    Those allergic to certain medications can safely use alternatives. For example, those who are allergic to penicillins and their derivative drugs can safely be given other antibiotics.

    Before administration of penicillin a small test may be performed to check for allergy. A highly diluted amount of the drug is injected into the skin over the forearm of the patient. If allergic the region shows redness and a reaction. It is important that all patients receive this skin test before being administered penicillin. Other antibiotics and allergens may be tested similarly.

    Persons who are allergic to painkillers such as non-steroidal anti inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can safely take paracetamol for example. People who are allergic to certain anesthetic agents may be anesthetized using alternatives and those allergic to certain blood pressure lowering agents like angiotensin-converting enzyme (ACE) inhibitors maybe prescribed other agents.

    Some persons might be severely allergic to contrast dyes and agents used for imaging studies. For example, contrast enhanced brain CT scans and MRI scans may be prescribed if a person has a suspected bleeding within the brain or a stroke. In these cases injections of antihistamines and corticosteroids given before the contrast agents may prevent an anaphylactoid reaction or at least reduce its severity.

  • Adrenaline auto-injectors

    Persons who have had a previous episode of anaphylaxis are prescribed an adrenaline auto-injector. The auto-injector needs to be carried on person at all times.

    An emergency card or bracelet with full details of the allergy should also be carried on person at all times. This helps identification of a susceptible person and if needed administration of the adrenaline.

    Heat denatures the adrenaline and so it cannot be left exposed in hot environments. In addition the auto-injector should be checked regularly for its expiry date and replaced. Initial symptoms of anaphylaxis should be promptly treated to prevent worsening.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Apr 24, 2013

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