Supportive care with nebulized therapy, vasopressors, antihistamines, or corticosteroids may be beneficial for specific symptoms, but these are not replacements for epinephrine and should be administered only after epinephrine.¹⁶ Patients should be observed after acute treatment to monitor for biphasic reactions or possible recurrence as the epinephrine wears off.¹⁸ Because initial clinical presentation cannot reliably predict biphasic or protracted anaphylaxis, observation periods must be individualized.¹⁶

Conclusion

With the growing population of persons with food allergies in the United States, education of medical staff, patients, and their caregivers is critically important. Avoidance of specific food allergens is recommended, and individuals with food allergy and their caregivers should be taught how to interpret ingredient lists on food labels.¹ In addition, all patients who have experienced anaphylaxis should be given a prescription for two epinephrine auto-injectors and instructed on proper self-administration.^16,18 Patients should be counseled to store epinephrine auto-injectors properly (avoiding temperature extremes) and to be cognizant of the expiration date.18 Lastly, the development of a written action plan for anaphylaxis is an important tool for managing this life-threatening condition.^16,20

Dr. Lieberman is a clinical professor of medicine and pediatrics in the Division of Allergy and Immunology at the University of Tennessee College of Medicine in Memphis, Tenn. This article was developed by Mylan Specialty, L.P.

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