Recognize common presentations of anaphylaxis and stop under-treating this deadly allergic reaction with tips from Dr. Olajumoke Fadugba, Assistant Professor of Medicine, University of Pennsylvania! We review the basic pathophysiology and the standard criteria for diagnosing anaphylaxis, treatment basics, the primary importance of epinephrine, and the utility of adjunctive therapies. Also included are great tips on counseling patients about auto-injectable epinephrine, and a reminder not to panic...even when you inject your own thumb?! ACP members can claim CME-MOC credit at https://acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).
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- Writer (interview, show notes & CME questions) and cover art: Emi Okamoto MD
- Infographic by: Emi Okamoto MD
- Hosts: Matthew Watto MD, FACP; Stuart Brigham MD
- Editors: Matthew Watto MD, FACP
- Guest: Olajumoke Fadugba MD
- Special thanks to Sarah Phoebe Roberts MPH for booking!
- 00:00 Intro and disclaimer
- 03:00 Guest one-liner, book recommendation, advice to fellows and trainees
- 07:15 Case of anaphylaxis with mucocutaneous and GI symptoms
- 09:05 Anaphylaxis (IgE mediated mast cell action) vs anaphylactoid (non-IgE mediated mast cell activation; e.g. contrast allergy, vancomycin)
- 12:34 Vancomycin and non-IgE mediated reactions
- 14:40 Common presentations of anaphylaxis and the three diagnostic criteria
- 22:09 Biphasic reactions and predicting severity
- 26:42 Counseling patients on the use of epinephrine
- 28:35 Stuart’s thumb question
- 30:00 Adjuvant medications: antihistamines and corticosteroids
- 33:20 Are there any contraindications to epinephrine use?
- 34:25 Use of tryptase levels when the diagnosis of anaphylaxis is uncertain
- 37:10 Outro