Saturday, December 29, 2007

anaphylaxis

this is an adverse response to a substance, usually a foreign protein or a drug, that the body is hypersensitive to. most of us call this an allergy, like the breaking of "hives" with a bee sting or when some people take prawns. drugs commonly implicated in this reaction include antibiotics (eg. penicillin) & pain-killers (eg. aspirin).

most reactions are mild, like a rash or an itch, but some are severe enough to be life-threatening, eg. an asthma-like attack or a marked drop in blood pressure. sometimes, death results if medical treatment is delayed.

this 20-yr-old girl was involved in an accident & needed surgery. but on the operating table, before the procedure could commence, she developed a sudden & drastic drop in blood pressure. as this is common during an anaesthetic, she was given intravenous fluids & ephedrine, a drug that raises blood pressure. it was when she failed to respond after repeated doses & the appearance of a rash over her arms & chest, that we realised this was an anaphylactic reaction.

the treatment of choice in this instance would be adrenaline (ephinephrine in the US)...

...the same stuff the body pumps out when in fright, fight or flight. the same stuff one would give for cardiac arrest or severe asthma, except that in anaphylaxis, a smaller dose would have increased the blood pressure sufficiently. a wonder drug indeed - often reliable & effective when in dire straits.

this girl responded well after a few repeated doses of adrenaline & given the circumstances, the safest course of action would be to postpone the non-urgent surgery till she has fully recovered from the effects of this life-threatening event.

now, who said doctors in private practice are always out for a quick buck??

4 comments:

stay-at-home mum said...

Yes, its terrible. My m-i-l was given the wrong medication by a doc (as a result of a wrong diagnosis) and suffered some damage to her internal organs (liver and kidney), and as a result, now suffers an allergic reaction to even the mildest medication for common ailments. We worry.

doc said...

SAHM,

we do not know who will be allergic to what until that person is exposed to it, so it's really unavoidable the 1st time.

once we do know of the allergy, then there are alternatives that can be prescribed, even for common ailments.

iml said...

My mum too had an allergy scare. Ulcers in her mouth and tongue were so bad she could hardly eat. My eldest, had her eyes rolled up as a result of an allergy reaction to medication prescribed to her.

doc said...

Iml,

allergies manifest in many forms, but most are mild.

your mum & eldest just have to remember to avoid that which they are allergic to. subsequent exposure may result in more severe reactions than the previous one.