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Anaphylaxis, chest pain, and ST elevation in aVR

Dr. Smith's ECG Blog

Sent by anonymous, written by Pendell Meyers A man in his late 40s presented to the ED with concern for allergic reaction after accidentally eating a potential allergen, then developing an itchy full body rash and diarrhea. In the ED he received methylprednisolone, diphenhydramine, and epinephrine for possible anaphylaxis.

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REBEL Core Cast 108.0 – Angioedema

REBEL EM

Urticaria and pruritus = MAST CELL mediated, which is treated like a standard allergic reaction. Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation.

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Cetirizine Vs Diphenhydramine For the Treatment of Acute Urticaria in the ED

REBEL EM

Background: Diphenhydramine, a first-generation antihistamine, is the most common pharmacologic agent used to treat acute allergic reactions. Patients were randomized in a 1:1 ratio. Diphenhydramine versus nonsedating antihistamines for acute allergic reactions: a literature review. 2005 Sep;116(3):643-9.