Anafilaksi

dr Putra Hendra SpPD

UNIBA

Anaphylaxis
Definition:
A life-threatening

allergic reaction that

causes shock (hypoperfusion) and airway
swelling

Referred

to as anaphylactic shock

Anaphylactic reactions
Anaphylactic

reactions are the immediate

type of hypersensitivity that result from
interaction of antigens with specific
antibodies bound to mast cells and
basophils.

They

involve the release of vasoactive

bronchoconstrictive substances such
as:Histamine, Leukotrienes, Chemotactic
factors.

Histamine release:
Increases

vascular permeability,
causing edema
Causes vasodilation
Constricts bronchial smooth muscle
Stimulates secretion from nasal,
bronchial and gastric glands
Also hives (skin), conjunctivitis (eyes)
and rhinitis (mucous membranes of
nose).

Symptoms and signs of

anaphylaxis
difficulty

and/or noisy breathing

swelling of the tongue
swelling or tightness in the throat
difficulty talking or hoarse voice
wheeze or persistent cough
dizzy/light headed
loss of consciousness and/or collapse
pale and floppy (young child)

Normal larynx

Laryngeal oedema

Primary management

Stop drug

Maintain the venous access

100% O2 and maintain

airway

Get help

Lay patient flat with legs

elevated

Administering EpiPen or EpiPen

Junior

Instructions from Action Plan for Anaphylaxis

www.allergyfacts.org.au/PDF/anaphylaxis_plan_(child)_au.pdf

TINDAKAN SEGERA
1. Hentikan pemberian prosedur (misal
memberi media kontras)
2. Pasang tourniquet (misal: setelah sengatan
tawon)
3. Letakkan pasien pada dasar keras, kaki
ditinggikan 30-40. Jika pasien tidak sadar
lakukan triple manuver. Jika pasien apneu
lakukan 2 kali ventilasi buatan dengan O2
murni. Jka edema larynx lakukan intubas
itrakhea. Untuk mengamankan sirkulasi RJP

1. Reaksi yang hebat memerlukan suntikan

IV 3-5 ml adrenalin 1:10.00( mg/ituk
dewesac 0,01 ml/kg untuk anak.
2. Reaksi yang lebih ringan suntikan IM/SC
0,3-0,5 ml adrenalin 1 :1.000 (0,3-Uk dewasa
dan 0,01 ml/kg untuk anak. Dosisulangan
seperlunya diberikan tiap 5-10 mei
6. Aminofilin diberikan IV jika
bronkhospasme menetap setelah pemberian
adregjkgBB lev infus 20 menitdilanjutkan
kontinyu 0,4-0,9 mg/kgBB^am
7. Jika tidak ada respon, berikan adrenalin
atau nor adrenalin 1 mg/ml diencerkan 10x

TINDAKAN SUPORTIF
Koreksi cairan dan elektrolit
Teruskan pemberian O2
Beri kortikoslerid IV 100-200 mg
Beri antihistamin IV, misal:
prometazin 0,2 mg/kgBB I
Hindari sedativa, narkotika,
transquilizer dan obat hipotensi lain

IgE Mediated:
Type I

Overreaction to an allergen that is contact through skin,

inhaled through lung, swallowed or injected.

Triggered by harmless substances such as; pollen, dust,

animal danders, food, can also occur as a result of drug

or bee stings or stings from other insects (an allergen).

An allergen; an antigen that causes allergy. Either inhaled,

ingested, .. Can be complete protein antigens (Pollen and
animal dander) or low molecular weight proteins.