Preparations for the treatment of anaphylactic shock
Last reviewed: 23.04.2024
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The drug treatment of anaphylactic shock should be lightning fast. Be sure to inject drugs intravenously, this will speed up their effect on the human body. The list of inputs should be limited. But, despite this, certain drugs must be included in it.
- Catecholamines. The most important of this group of drugs is Adrenaline. Due to a certain stimulation of adrenoreceptors, it will allow to narrow the vessels, as well as reduce the activity of the myocardium. In addition, adrenaline significantly increases cardiac output, and also has a bronchodilator effect. To enter it it is necessary at a rate of 0,3-0,5 ml 0,1%. It can be administered as a mixture. Usually it consists of 1 ml of a 0.1% solution of adrenaline and a solution of sodium chloride, in a volume of 10 ml. Probably, repeated introduction within 5-10 minutes.
- Glucocorticosteroids. In general, Prednisolone, Dexamethasone, Metiprednisolone, Hydrocortisone are used. They are administered from the calculation of 20-30 mg of the drug per kilogram of weight. This will help to establish a positive dynamics of the patient. Drugs of this category can significantly inhibit the effect of allergens on capillaries, thereby reducing their permeability.
- Bronchodilators. Among them, Euphyllin is actively used. It helps to reduce the release of histamine metabolites, thereby reducing bronchospasm. It should be administered intravenously at a dosage of 5-6 mg / kg for 20 minutes. If there is an urgent need, the administration is repeated, thereby proceeding to a maintenance dose of 0.9 mg / kg / h.
- Infusion therapy. It is in the introduction of 0.9 sodium chloride solution, acesol, 5% glucose solution. Due to their significantly increased blood circulation volume, there is a vasoconstrictive effect.
- Antigiapamine preparations. Drugs of this group can effectively affect the condition of a person. Prevent or completely eliminate Quincke's edema and hives. They can reduce the action of Histamine on the body. This leads to relief of attacks of anaphylactic shock. It is simple to introduce 1-2 ml of Tavegil or Suprastin solution.
Adrenalin
With the anaphylactic state, it is injected slowly intravenously, in a dosage of 0.1-0.25 mg. It is desirable to dilute it in a 0.9% solution of sodium chloride. If necessary, the administration continues, but at a concentration of 0.1 mg / ml. If a person does not have a critical condition, then it is quite possible to administer the drug slowly, diluted or not diluted. Repeat manipulation is repeated after 20 minutes. The maximum number of repetitions should not exceed 3.
Adrenaline helps to increase and increase heartbeats. This is possible with its rapid introduction. In addition, it increases the amount of blood flow, and also has anti-allergic effect. Thanks to it, muscle relaxes. If the administered dose is 0.3 μg / kg / min, the renal blood flow decreases, and gastrointestinal motility is maintained. The effect is achieved immediately after the administration of the drug.
Use adrenaline is not possible with hypersensitivity, hypertension, tachyarrhythmia, pregnancy, as well as during lactation. If the dosage is incorrect, it can lead to the appearance of overdose symptoms. Everything manifests itself in increased pressure, vomiting, headache. It is possible to develop a myocardial infarction, as well as a fatal outcome. The agent is capable of causing side effects. These include angina pectoris, chest pain, dizziness, nervousness, fatigue, nausea and vomiting.
Epinephrine
The action of the drug consists of cardiostimulation, narrowing of the vessels, and also a decrease in pressure. The drug has a pronounced effect on the smooth muscles of the internal organs. Also improves the work of metabolic processes in the body. Most often, the medication is used for anaphylactic shock, insulin overdose, and open-angle glaucoma.
The main contraindications are arterial hypertension, diabetes mellitus, pregnancy, atherosclerosis and angle-closure glaucoma. Naturally, the drug is inappropriate to use when hypersensitivity to it. The agent is capable of causing side effects. These include anxiety, nausea, increased blood pressure, and headache.
Use the medicine with caution. So, it is injected intramuscularly by 0.3-1 ml of 0.1% solution. If the heart stops, the dosage is 1: 10000 in diluted condition. Perhaps its growing introduction, literally every 5 minutes. Often the drug is used to stop bleeding. For this, the tampon should be moistened in a solution of the medicine. In addition, it is used as eye drops.
Glucocorticoids
Glucocorticoids after passing through the membrane of the cell bind to a specific steroid receptor. Thus, stimulation and formation of information RNA occurs. As a result, various regulatory proteins begin to be synthesized on the ribosomes. One of them is lipocortin. It suppresses the work of prostaglandins and leukotrienes. They are responsible for the development of the inflammatory process. To feel the effect after applying these medications, you will have to wait a few hours. In medical practice, most often used Beclomethasone, Flunisolide, Budesonide, Triamcinolone and Fluticasone.
- Beclomethasone. Is one of the most common means. With prolonged use, patients feel a significant improvement. It is used by inhalation, at 200-1600 mg / day. This dosage is divided into 2-3 doses. The agent should be used with extreme caution. It can not be used by pregnant women, as well as people with hypersensitivity. It can lead to the appearance of headache, nausea and weakness.
- Flunisolide. By its action, it is slightly inferior to the presented medicines. True, it is used in a higher dosage. A person should use 1000-2000 mcg / day in 2 divided doses. The main contraindication is hypersensitivity. Pregnant, during lactation, as well as people with impaired liver and kidney function is prohibited. Possible side effects in the form of nausea, vomiting, weakness, increased pressure.
- Budesonide. It is an effective glucocorticoid. Minimally affects the function of the adrenal glands, the effect of the first passage is carried out in the liver. If you use it in inhalation form, the effect is much better and faster. The drug must be administered with a stationary inhaler, in a dosage of 2 mg. The effect can be seen within an hour. Use the drug is not possible with hypersensitivity, as well as infectious diseases of the respiratory system. Side effects: cough, irritation of the larynx.
- Triamcinolone. By its effectiveness, it is 8 times superior to prednisolone. It is introduced by inhalation, at 600-800 mcg / day for 3-4 doses. The maximum dosage per day should not exceed 1600 μg. Contraindications include tuberculosis, diverticulitis, herpesvirus, diabetes, syphilis. Side effects: swelling, increased blood pressure, insomnia, mental disorders.
- Fluticasone. This drug is the newest among glucocorticoids. It has a higher activity. It is enough to apply it at a dosage of 100-500 mg / day to see a positive result. The maximum dosage should not exceed 1000 mg / day. Contraindications: increased hypersensitivity, itching of the genitals and children under 1 year. Side effects: itching, burning, allergic reactions, hoarseness of the voice.
Prednisolone
The dosage of the drug should be calculated individually. In an acute condition, usually apply 20-30 mg per day, this is equivalent to 4-6 tablets. An appointment at a higher dosage is possible. Treatment stops slowly, gradually reducing the basic dose. With anaphylactic shock, the medication is administered in the amount of 30-90 mg intravenously or by drop. The main thing that the introduction was slow.
The agent can cause the development of side effects. These include the violation of the menstrual cycle, obesity, ulcers of the digestive tract, defects in the walls of the stomach and intestine. Use the drug is not possible with hypersensitivity, severe forms of hypertension, pregnancy, psychosis and nephritis.
This drug is actively used in anaphylactic shock. It is included in the algorithm of urgent actions. In fact, it's almost impossible to do without it. He is in second place after the introduction of adrenaline.
Dexamethasone
Use the product in high doses. This concerns the period of acute manifestation of the problem, and also at the very beginning of its development. Once the desired effect is achieved, it is worthwhile to revise the dosage and designate it in a supportive form. Higher doses are no longer appropriate at this stage. The dosage regimen is of an individual character. If a person's condition is severe, it is necessary to take a remedy for 10-15 mg per day. As for the maintenance dose, it is up to 4.5 mg. At an asthmatic status it is necessary to apply a medicine on 2-3 mg a day. The duration of use is determined by the attending physician.
As for contraindications, it is not possible to apply medication with hypersensitivity to its main components. In general, there is no detailed information. This drug can be considered universal, because it is often used to eliminate severe allergic reactions. There were no data on side effects. This remedy is partly safe and is used universally.
Antihistamines
With anaphylactic shock, the use of these drugs is not prescribed. After all, they have too weak an effect and are not able to help a person quickly. Drugs of this type can reverse the pressure drop. In addition, the necessary elimination of bronchospasm does not occur. In more severe cases, it is still recommended to use H1-diphenhydramine. It is administered intravenously or intramuscularly. The use of this type of medicine does not allow the occurrence of an allergic reaction repeatedly. For this, Suprastin or Dimedrol is widely used. The introduction is made intramuscularly.
For the victim must be constantly monitored, because there is a chance of reverse action and increased symptoms. At high pressure it is recommended to resort to Pentamnna - 1ml of 5% solution in 20 ml of isotonic sodium chloride solution. The specificity of treatment depends entirely on the condition of a person. As mentioned above, most often resort to the help of Suprastin, he also enters the "anxious set".
Suprastin
The agent is applied during meals, to 0.025 grams, up to 3 times a day. If the condition is severe, in this case it means an allergic reaction with a complicated course, it is necessary to make intramuscular and intravenous injection. It is enough 1-2 ml of 2% solution. In acute conditions, a single administration is recommended.
The drug can cause side effects. Usually they include drowsiness and general weakness. The agent is not capable of acting negatively on the body. On the contrary, it helps him, cope with the impending danger.
There are also contraindications regarding the use of the drug. So, it is undesirable to use it for people whose profession requires maximum concentration. The speed of response in this case is significantly reduced. You can not inject drugs to people with hypertrophy and glaucoma. Naturally, the special group of risk includes victims who have a persistent allergic reaction to this medication.
Adrenomimetics
Among the adrenomimetics include several types of drugs. It can be a stimulant. When eliminating a persistent allergic reaction, apply Epinephrine, Adrenaline. The means involved in stimulating adrenergic receptors include Metazone. Salbutol and Terbutaline are also widely used.
Epinephrine. It is an analog of the hormone of the brain substance. The drug is able to excite absolutely all types of adrenoreceptors. They actively increase the pressure, and also increase the heart rate. There is an expansion of the vessels of the skeletal musculature.
Adrenalin. It is able to reduce precapillary sphincters. In the end result there is a disturbance of microcirculation in peripheral tissues. There is an active blood supply to the heart, brain and skeletal muscles. True, a significant increase in pressure can lead to the development of a bradycardia.
All funds related to adrenomimetics are administered intravenously or intramuscularly. They are based on the content of adrenaline, which stimulates the work of many functions and the system, due to the enhancement of metabolic processes.
Eufillin
Assign the agent inward, inject it intravenously or intramuscularly. Under the skin, the introduction is not performed, since the risk of developing irritation is great. The way of application is completely dependent on the specific situation. In severe cases, use intravenously, the injection slowly (4-6 minutes). Dosage 0.12-0.24 g.
The drug can cause side effects, including dyspeptic disorders. If the administration is intravenous, there may be dizziness, low pressure. Often there is a headache, convulsions, palpitations. If rectal - irritation of the intestinal mucosa.
The medication has a number of contraindications. Do not use it at low blood pressure. People with paroxysmal tachycardia, epilepsy, extrasystoles get into the risk zone. You can not use it for heart failure, as well as coronary insufficiency and heart rhythm disturbance.