Sudden unexpected food allergy - best to try to throw up or not? (do not need answers fast)

[DSeid]

Yup.

Ironically auto-correct is not my friend’

[puzzlegal]

There are also antihistamine strips, that kinda melt in your mouth and don’t need the coordination of swallowing a pill. That’s what my husband keeps on his first aid kit, as they can be purchased OTC, without a prescription. Those same strips could probably be used rectally, but i haven’t read the label in several years.

[nearwildheaven]

I’ve seen those. They would also be useful for young children.

[Nyvaak]

@nearwildheaven

Epi-Pens are like Narcan in that people who carry them should not hope to need them, and if they are used, 911 should also be called.

Yes, definitely. Both are lifesaving measures in the near term, but are not substitutes for definitive care - Narcan because its half-life in the body is shorter than most narcotics (sorry, not intending a hijack) and epi because . . . well, anaphylaxis is just weird.

Many anaphylactic reactions come on quickly and are quickly fixed with a shot of epi. But many require two or even way more shots, depending on the individual person and individual reaction.

There are also, somewhat unusually, biphasic reactions, in which the person recovers long enough for everyone to breathe a sigh of relief and decide that the emergency has passed. Then hours later it starts again, sometimes much worse. (Source: articles I don’t have access to right now - sorry - and personal experiences.)

Bottom line: if the reaction is severe, or there is ANY reason to think it will be, use the epi ASAP, then hope it’s bought you enough time to reach definitive care.

[Nyvaak]

Also: if the person having the reaction is a child, give the epi yesterday !

[DSeid]

@Nyvaak

articles I don’t have access to right now

Or just look in the guideline article I linked to.

Biphasic anaphylaxis is recurrent anaphylaxis occurring 1 to 72 hours after resolution of an initial anaphylactic episode, though an outside limit of 78 hours has also been suggested.35,36 Estimates of biphasic anaphylaxis vary from <1% to 20% of patients; however, the ability of antihistamines and glucocorticoids to affect this outcome is unclear.37-44 Despite a lack of clear evidence supporting the role of antihistamines and glucocorticoids in anaphylaxis, these agents continue to be routinely used in anaphylaxis management. …

… The JTFPP findings suggest biphasic anaphylaxis is associated with a more severe initial presentation of anaphylaxis (odds ratio [OR], 2.11; 95% CI, 1.23-3.61) or repeated epinephrine doses (ie, >1 dose of epinephrine) required with the initial presentation (OR, 4.82; 95% CI, 2.70-8.58). Additional risk factors include wide pulse pressure (OR, 2.11; 95% CI, 1.32-3.37), unknown anaphylaxis trigger (OR, 1.63; 95% CI, 1.14-2.33), cutaneous signs and symptoms (OR, 2.54; 95% CI, 1.25-5.15), and drug trigger in children (OR, 2.35; 95% CI, 1.16-4.76). … Prompt and adequate treatment of anaphylaxis appears central to reducing biphasic anaphylaxis risk, in the opinion of the JTFPP. While the possibility of biphasic anaphylaxis should be emphasized in this higher risk group, it is important to educate all patients regarding the chance of a biphasic reaction as well as avoiding known triggers, identification of symptoms of anaphylaxis, the use of auto-injector epinephrine for the treatment of anaphylaxis, and timely follow-up with an allergist. …

… We suggest against administering glucocorticoids or antihistamines as an intervention to prevent biphasic anaphylaxis. …

[puzzlegal]

Thank you for looking up solid FQ references.

[Nyvaak]

@DSeid

Or just look in the guideline article I linked to

Ha ! Yes indeed. Looks like I should’ve read ALL the way through. Thanks again.

[DSeid]

Thank you for having posted this about scombroid.

Today I took out some lox that had been sitting in the back of the refrigerator drawer for a long time and figured I’d use it up for breakfast on a slice of pumpernickel. Half way through I felt stingy all over and looked to see that I was flushed everywhere.

I’ll never know for sure if it was scombroid but based on having read about it here I immediately took a Claritin and a Zantac. Tossed the rest. Within the hour I was feeling better.

Could have just been some other something weird but funny coincidence!