Epinephrine is the only effective treatment for anaphylaxis

Many people have experienced mild allergic reactions to a food, medication, or other allergen, but a severe reaction can be harmful or even fatal. Anaphylaxis must be treated with epinephrine as quickly as possible, followed by a visit to a hospital emergency room for observation. The post Epinephrine is the only effective treatment for anaphylaxis appeared first on Harvard Health Blog.

Epinephrine is the only effective treatment for anaphylaxis

Anaphylaxis is a severe allergic reaction that can potentially lead to death if not promptly treated. Allergic reactions typically begin suddenly after exposure to an allergen, which may be a food, medication, insect sting, or another trigger. Anaphylaxis can occur in anyone at any time; it can sometimes be triggered by allergens that a person has only had mild reactions to in the past — or to which they have never reacted to before.

Recognizing anaphylaxis

A mild allergic reaction may consist of hives, itching, flushing, swelling of the lips or tongue, or some combination of these.

However, throat swelling or tightening, trouble breathing, wheezing, shortness of breath, cough, lightheadedness, fainting, abdominal cramps, nausea, vomiting, diarrhea, or a sense of impending doom, are all symptoms of anaphylaxis. The symptoms of an anaphylactic reaction can vary from one episode to the next, even in the same individual.

How should anaphylaxis be treated?

It is important to quickly recognize anaphylaxis so it can be promptly treated with epinephrine, the first-line treatment for anaphylaxis. Epinephrine is a hormone made by the adrenal glands. It works within minutes to prevent progression and reverse the symptoms of anaphylaxis.

People may wonder if they should administer epinephrine if they suspect — but aren’t sure — that they are having an anaphylactic reaction. The answer is yes. Epinephrine should be administered without delay if there is any concern or suspicion of anaphylaxis, because the risk of an untreated severe allergic reaction outweighs the risk of inappropriately receiving epinephrine.

Furthermore, delays in epinephrine administration can result in more severe reactions, and possibly even death. Individuals carrying an epinephrine autoinjector (EpiPen, Auvi-Q, Adrenaclick, others) should use it immediately if they suspect an anaphylactic reaction, and then call 911. If you don’t carry an epinephrine autoinjector, call 911 right away.

Anyone who has been treated with epinephrine after an anaphylactic reaction should be transported by ambulance to an emergency room, where they will continue to be monitored. This is because some people who have had an anaphylactic reaction may have protracted anaphylaxis, with symptoms lasting several hours (or possibly days). Others may have biphasic anaphylaxis, which is a recurrence of symptoms several hours (or possibly days) after symptoms resolve, even without further exposure to the allergic trigger. For both protracted and biphasic anaphylactic reactions, the first-line treatment remains epinephrine. Biphasic reactions can occur up to three days after the initial anaphylactic reaction, which means you may develop symptoms even after being discharged from the emergency room.

Is there a role for antihistamines or glucocorticoids in anaphylaxis?

There is no substitute for epinephrine, which is the only first-line treatment for anaphylaxis. Neither antihistamines nor glucocorticoids work as quickly as epinephrine, and neither can effectively treat the severe symptoms associated with anaphylaxis.

However, antihistamines such as diphenhydramine (Benadryl) or cetirizine (Zyrtec), glucocorticoids like prednisone, or a combination, may be used in addition to epinephrine in some cases of anaphylaxis, after epinephrine is administered.

Antihistamines can relieve some symptoms of a mild (non-anaphylactic) allergic reaction, such as hives, itching or flushing, usually within an hour or two after they are given. Glucocorticoids take even longer to have an effect, so they are not useful for the treatment of any acute symptoms.

As noted in anaphylaxis practice guidelines published in the Journal of Allergy and Clinical Immunology, neither antihistamines nor glucocorticoids have been shown effective in preventing biphasic anaphylaxis, so they should not be given routinely after immediate allergy symptoms have resolved. However, some patients may benefit from a short course of glucocorticoids, for example if they had severe facial swelling or asthma symptoms related to their anaphylactic reaction.

How to prevent future anaphylactic reactions

Anyone who has had anaphylaxis is at increased risk of experiencing anaphylaxis again. Unless there is minimal risk of re-exposure to the allergen, you should carry an epinephrine autoinjector with you at all times. In addition, you should see an allergist for further evaluation and management, especially if there is any doubt about what triggered your anaphylaxis or whether you may have other allergic triggers. Finally, do your best to completely avoid your allergic trigger, as even small amounts can cause a severe allergic reaction.

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Sweet or tart, cherries are the bomb

A dietitian shares 6 surprising health reasons why you should eat this magical fruit.

Sweet or tart, cherries are the bomb
Cherries are seemingly magical. They are incredibly good for your health. (For Spectrum Health Beat)

Michigan is home of the Cherry Capital of the World and produces more tart cherries than any other state.

So it’s good news for Michigan residents—and those beyond—that cherries offer several unique and well-researched health benefits.

Greg Stacey, a dietitian with Spectrum Health, is a firm believer in eating cherries and drinking cherry juice. Not only are cherries low in calories (75 to 100 calories per cup), they are bursting with vitamins, minerals, fiber and antioxidants.

“Over time, I was bombarded with articles about cherries,” he said. “Finally I said, ‘This is something I need to eat every day.’”

Stacey’s top 6 health reasons why you should eat cherries:

1. Cherries help athletes recover more quickly.

Research shows that tart cherry juice will improve athletic performance and recovery in both strength and endurance events, Stacey said.

“If you drink 8 to 10 ounces before the event, you will perform better,” he said. “And if you drink another 8 to 10 ounces after the event, you will recover quicker.”

The reason: cherries’ carbohydrates provide energy, electrolytes keep you well hydrated, and antioxidants decrease inflammation and oxidative stress, Stacey said. Research shows that cherry juice alone can reduce markers used to measure inflammation by 20%.

So, if athletes are looking for a simple, natural alternative to sports drinks for before and after a workout, use Stacey’s recipe: 1 cup to 1 ½ cups tart cherry juice mixed with one liter of water.

2. Cherries can improve your memory.

Stacey said this claim is well studied and has proven true for sweet cherries (as opposed to tart cherries).

One study gave elderly patients with dementia 200 ml (just under a cup) of cherry juice every day for eight weeks and compared them with a group of patients who drank another juice without antioxidants.

The result for the patients drinking cherry juice: improved short-term memory, long-term memory and verbal fluency.

3. Cherries can lower your blood pressure.

A cup of cherry juice or two cups pitted (three cups non-pitted) of sweet or tart cherries can improve your blood pressure. In fact, one study showed cherries lowered systolic blood pressure as much as 10 points. Stacey attributes this to antioxidants, as well as the high potassium content of cherries.

“Less than 3% of Americans get enough potassium,” he said. “And most Americans eat a lot of sodium. Sodium and potassium create a balance in our bodies.”

Cherries can improve that balance, and therefore lower blood pressure. (Other great sources of potassium, Stacey said, are bananas with 400 mg and potatoes with 1,600 mg.)

4. Cherries can lower your cholesterol.

To use cherries to help lower cholesterol, Stacey said, you must eat whole cherries, as juice doesn’t do the trick. That’s because whole cherries have high fiber content, which helps our body eliminate bile and therefore lower cholesterol.

The average American eats 10 to 15 grams of fiber per day, while the standard for women is 25 grams and for men is 38 grams, Stacey said.

So anything, like cherries, that adds fiber to your diet is great for you.

5. Cherries can improve gout and arthritis.

Because gout and arthritis are both inflammatory diseases, cherries can help reduce symptoms.

In fact, studies show 2-3 cups of sweet cherries alone can cut gout attacks in half. Eating cherries plus taking medicines the doctor prescribes for gout can reduce gout attacks by up to 75%, Stacey said.

That’s sweet news for gout sufferers.

6. Cherries can help you get better Zzzs.

Cherries contain melatonin, a hormone that helps regulate sleep.

According to one study, which Stacey said showed a “significant but not profound” effect, people who ate two cups of cherries or drank one cup of cherry juice fell asleep faster and woke up less during the night.

Even better, by the way, are raspberries, which contain more melatonin than cherries.

So if you’re looking to improve an already healthy diet, Stacey urges incorporating eating cherries (or raspberries, blackberries or blueberries) into your daily routine.

“While cherries, and all berries, are very, very good for us, no one food is going to set you on the path to good health,” he said. “Eating a healthy diet and avoiding processed foods, candy and soda is the main predictor of health. …You can’t eat a cheeseburger and ice cream and then throw some cherries in there and think you have eaten well.”

If you do decide to add cherries to your diet, Stacey urges washing fresh cherries well before eating. And while fresh is best, frozen cherries are great, too.

For cherry juice, he recommends fresh squeezed, but juice concentrate also works.

“Whatever way gets more cherries in your diet is what’s best for you,” he said.

Source : Health Beat More   

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