Prevention of Anaphylaxis
ÎAvoidance management should be individualized, taking into consideration factors such as age, activity, occupation, hobbies, residential conditions, access to medical care, and the patients' level of personal anxiety. (C)
ÎEven in cases when the allergen is known, avoidance measures may not always be successful. Therefore, patients should be instructed in self-management of anaphylaxis. (C)
ÎVIT is successful in preventing anaphylaxis in up to 98% of patients who have previously experienced venom-induced anaphylaxis. (A)
ÎPharmacologic prophylaxis should be used in select situations, eg, to prevent recurrent anaphylactic reactions to radiographic contrast material and fluorescein, as well as to prevent idiopathic anaphylaxis. In these specific situations, prophylaxis with glucocorticosteroids and antihistamines may reduce the occurrence of subsequent reactions. (C)
ÎDesensitization to medications that are known to have caused anaphylaxis can be effective. The desensitization is temporary, and if the medication is required in the future, the desensitization process must be repeated. (C)
ÎPatient education might be the most important preventive strategy. Education can emphasize hidden allergens, cross-reactivity between various allergens and drugs, unforeseen risks during medical procedures, and when and how to use self-administered epinephrine. Physicians should educate patients about the risks of future anaphylaxis, as well as the benefits of avoidance measures. (B)
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