Prevention of Anaphylaxis

The saying “prevention is better than cure” can not be truer in life threatening medical conditions such as anaphylaxis. It is always better to prevent a disease especially if it is life threatening, if possible.

In case of anaphylaxis, prevention requires knowledge of several aspects and there are multiple factors that need to be considered in successfully preventing anaphylaxis. An important aspect is the sensitivity of the individual, and if a person is sensitive with a definite history of a past anaphylactic reaction it is always best to use an agent which is structurally different from the agent which caused anaphylactic reaction, even if it was only mild, for treatment/diagnostic purpose. For example beta blockers are contraindicated (and should not be used) if a person is undergoing immunotherapy for respiratory system allergy or is sensitive to Hymenoptera venom. Character of the diagnostic or therapeutic agent and the route of administration and absorption are important in preventing anaphylaxis. Cross reactivity is an important aspect to consider in preventing anaphylaxis, e.g. cephalosporins have cross reactivity with the penicillins, due to similar cross-reactive ring structure and a person sensitive to cephalosporins will be sensitive to penicillins and vice versa.

If any intradermal injection is given to a person, a prick or scratch skin test should be done prior to intradermal injection, especially for agents which has high risk of anaphylactic reactions, such as allergenic extracts. Skin testing for antibiotics such as penicillin should be done prior to administration.

To prevent anaphylaxis desensitization can be done by giving graded quantities of the drug by the selected route using double doses until a therapeutic dosage is achieved. But this should be done only in settings equipped with resuscitation equipment and an IV (intravenous) line is in place.

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