Exercise-Induced Anaphylaxis Medication

Updated: Aug 24, 2017
  • Author: Peter N Huynh, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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Medication

Medication Summary

If the syndrome has progressed to anaphylaxis, then intramuscular epinephrine or emergency self-injectable epinephrine (eg, Adrenaclick, EpiPen, Twinject) is the drug of choice.

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Sympathomimetic agents

Class Summary

Epinephrine, administered intramuscularly, is the drug of choice for the treatment of severe anaphylaxis in a patient with exercise-induced anaphylaxis. Epinephrine antagonizes the effects of the chemical mediators, including histamine and leukotrienes, on smooth muscle and blood vessels.

Epinephrine (Adrenaclick, EpiPen, EpiPen Jr, Twinject)

Epinephrine should be administered intramuscularly in the mid-anterolateral thigh. This agent possesses alpha-agonist effects that include increased peripheral vascular resistance, reversed peripheral vasodilatation, systemic hypotension, and vascular permeability. The beta-agonist effects of epinephrine include bronchodilatation, chronotropic cardiac activity, and positive inotropic effects.

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Antihistamines

Class Summary

These agents are used to treat minor allergic reactions and anaphylaxis. They prevent histamine response in sensory nerve endings and blood vessels. These agents are more effective in preventing histamine response than in reversing it. They act by competitive inhibition of histamine at the H1 receptor. This mediates the wheal-and-flare reactions, bronchial constriction, mucus secretion, smooth muscle contraction, edema, hypotension, CNS depression, and cardiac arrhythmias.

Diphenhydramine (Benadryl, Benylin)

Diphenhydramine is indicated for symptomatic relief of symptoms caused by release of histamine in allergic reactions.

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Beta2-adrenergic Agonist Agent

Class Summary

Beta-agonists relax bronchial smooth muscle by action on beta2 -receptors, with little effect on cardiac muscle contractility. These agents are used in the prevention of exercise-induced bronchospasm.

Albuterol

Albuterol is indicated for the prevention of exercise-induced bronchospasm and for adults and children aged 4 years and older for the treatment or prevention of bronchospasm with reversible obstructive airway disease.

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Corticosteroids

Class Summary

Corticosteroids help to control severe allergic conditions intractable to conventional treatment in patients with serum sickness and drug reactions. Corticosteroids may prevent protracted or biphasic symptoms during acute anaphylaxis. However, they do not provide rapid relief of upper or lower airway obstruction, shock, or other symptoms of anaphylaxis.

Prednisone

Prednisone is an immunosuppressant for the treatment of allergic reactions. It may decrease inflammation by reversing increased capillary permeability and suppressing polymorphonuclear neutrophil activity.

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