When Medicines Fight Back: Allergies and Anaphylaxis

Morrow Family Medicine, a Member of Village Medical, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine, A Member of Village Medical one that will remind you of the way healthcare should be.  At Morrow Family Medicine, a Member of Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Morrow Family Medicine, and Host of To Your Health with Dr. Jim Morrow

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

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The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

Allergic Reactions

• An allergy occurs when the body overreacts to an allergen or ‘trigger’ that is typically harmless to most people.
  • Examples of allergies include
    • hay fever,
    • asthma,
    • eczema,
    • hives
    • and food allergy.
    • Estimates suggest that about one person in four is allergic to something and roughly half of all allergy sufferers are children.
    • The symptoms of an allergy range from mild to severe.
    • The most severe type of allergic reaction is anaphylaxis, which may cause death without prompt medical attention.
    • In most cases, effective treatments are available to manage or treat allergy symptoms.

Symptoms of allergies

• Symptoms depend on the allergy, but may include:
  • Swelling of lips, face, eyes.
  • Runny nose.
  • Red, watery and itchy eyes.
  • Wheeze or persistent cough.
  • Breathing problems.
  • Swelling tongue and tightness of throat.
  • Skin rash.
  • Stomach pains.
  • Vomiting and diarrhea.
• Do not self-diagnose. The symptoms and signs of allergies are common to many other medical conditions. It is important to see your doctor for professional diagnosis and treatment.

Common allergens

• A substance in the environment that can cause an allergic reaction in susceptible people is called an ‘allergen’.
  • There are many different allergens, but they all share one thing in common – protein.
  • Some allergens don’t contain protein to begin with, but bind with protein once inside the body to provoke the allergic reaction.
• Common allergens include:
  • Food – such as crustaceans, eggs, fish, milk, peanuts, tree nuts (for example, almonds, cashews, pecans and walnuts), sesame and soy products.
  • Plants – pollen from grasses and plants.
  • Medicines – including prescription medications (such as penicillin), over-the-counter medicines (such as aspirin) and herbal preparations.
  • Insects – such as dust mites and the venom from bees, ticks, ants and wasps.
  • Molds – such as mushroom and mould spores.
  • Animal dander – such as the fur and skin flakes from domestic pets such as cats and dogs.
  • Chemicals – including industrial and household chemicals and chemical products such as latex rubber.

The immune system reaction

• Allergy is the result of mistaken identity.
  • An allergen enters the body and is wrongly identified by the immune system as a dangerous substance.
  • In response, the immune system makes antibodies to attack the allergen. These are specific antibodies of the IgE (immunoglobulin E) class.
  • When an allergen is found, IgE antibodies trigger a cascade of immune system reactions,
    • including the release of chemicals known as mast cell chemicals.
    • These are substances that the body normally uses to destroy micro-organisms.
    • The most common of these is histamine.
      • In small amounts, histamine causes itching and reddening of the local area.
      • In large amounts, the nearby blood vessels become dilated and the area swells with accumulated fluid.
      • The immune system’s tendency to overreact to a harmless substance is thought to be genetic.
        • The term ‘atopy’ describes this genetic tendency.
        • Doctors describe a person who has an allergy as being ‘atopic’ – such people usually have raised levels of IgE in their blood.

What Is Anaphylaxis?

• Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death.
• Symptoms usually involve more than one organ system (part of the body), such as the skin or mouth, the lungs, the heart and the gut.
• Some symptoms include:
• Skin rashes, itching or hives
• Swelling of the lips, tongue or throat
• Shortness of breath, trouble breathing or wheezing (whistling sound during breathing)
• Dizziness and/or fainting
• Stomach pain, bloating, vomiting or diarrhea
• Uterine cramps
• Feeling like something awful is about to happen
• Ask your doctor for a complete list of symptoms and an anaphylaxis action plan.
  • Anaphylaxis must be treated right away to provide the best chance for improvement and prevent serious, potentially life-threatening complications.

What Is the Treatment for Anaphylaxis?

• Epinephrine is the most important treatment available.
  • Always carry two epinephrine auto-injectors so you can quickly treat a reaction wherever you are.
• Promptly inject the medicine at the first sign of an anaphylactic reaction. 
  • Consider carrying your anaphylaxis action plan along with your auto-injectors.
• Call 911 to go to a hospital by ambulance. You must seek medical care immediately– even if you feel better – because symptoms can recur.
• You may need other treatments, in addition to epinephrine.

What Causes Anaphylaxis?

• An allergy occurs when the body’s immune system sees something as harmful and reacts.
  • Your immune system tries to remove or isolate the trigger.
  • The result is symptoms such as vomiting or swelling.
  • The most common triggers of anaphylaxis are allergens.
  • Medicines, foods, insect stings and bites, and latex most often cause severe allergic reactions.
• Medicines are the leading cause in adults
  Common culprits are penicillin and other antibiotics, aspirin and aspirin-related products and insulin.
• Foods are the leading cause in children
  In the U.S., the most common food allergies are
  • peanuts,
  • tree nuts,
  • shellfish,
  • fish,
  • milk,
  • eggs,
  • soy
  • and wheat.
  • These are the “top 8 allergens.” In children, the most common food allergies are milk, eggs, peanuts, soy and wheat. In adults, the most common food allergies are shellfish, tree nuts and peanuts.
• Insect stings and bites
  • Stinging insects such as bees, wasps, hornets, yellow jackets and fire ants can cause anaphylaxis.
  • Certain tick bites can cause a person to develop severe allergic reactions to meat.
• Latex
  • Natural rubber latex may cause a mild skin irritation or it can trigger a severe allergic reaction.
    • Direct contact with latex items (latex gloves, condoms and balloons) can cause a reaction.
    • Inhaling small latex particles that have become airborne can trigger latex allergy.
    • Putting on and removing latex gloves can release small latex particles into the air.
  • Physical activity
    • Exercise-induced anaphylaxis is a rare allergic reaction that occurs after vigorous physical activity.
      • Temperature, seasonal changes, drugs, alcohol or eating certain foods before exercise may be co-factors.
      • In other words, both exercise and this other factor have to be present for a person to have the severe allergic reaction.
    • With proper evaluation, allergists identify most causes of anaphylaxis.
      • Some people have allergic reactions without any known exposure to common allergens.
        • If an allergist cannot identify a trigger, the condition is idiopathic anaphylaxis.

How Can I Tell the Difference Between

Anaphylaxis and Asthma?

• People with asthma often have allergies as well.
  • This puts them at higher risk of developing anaphylaxis, which also can cause breathing problems.
  • For that reason, it is important to manage your asthma well.
  • Some of the symptoms of a severe allergic reaction or a severe asthma attack may seem similar.
  • A helpful clue to tell the these apart is that anaphylaxis may closely follow ingestion of a medication, eating a specific food, or getting stung or bitten by an insect.
• If you are unsure if it is anaphylaxis or asthma:
• Use your epinephrine auto-injector first (it treats both anaphylaxis and asthma).
• Then use your asthma relief inhaler (e.g. albuterol).
• Call 911 and go to the hospital by ambulance.

What Can I Do to Prevent Anaphylaxis?

• Know your allergens.An accurate diagnosis is important. An allergist can help you create a plan to keep you safe.
• Avoid your allergens.
  • If you have a drug allergy, be familiar with both the generic name and brand names of medicines that cause you to have a severe allergic reaction.
    • And be aware of ingredients in a combination product.
    • Become familiar with medicines that might cause a cross-reaction. Read drug information carefully.
  • If you have a food allergy, be careful about everything you eat.
    • Check ingredients on all food labels. Wash hands, and use clean surfaces and utensils to prepare food.
    • Ask restaurant staff how they prepare foods
  • If you react to insect stings or exercise, talk to your doctor about how to avoid these reactions.
• Carry your epinephrine auto-injectors with you at all times.This is very important and can save your life or the life of a loved one.
• Prepare with a plan.Have your doctor help you create an anaphylaxis action plan.
• Talk to your doctor and caregivers.Make sure they know the names of any medications you are allergic to and what symptoms you had when you took them. Give them a list of every drug you take. Some common medicines, like beta-blockers, can worsen anaphylaxis.
• Wear a medical ID bracelet or necklace.It lets others know of your allergy in an emergency. Also, keep a card in your wallet or purse that explains your allergy.

Who Is At Risk for Anaphylaxis? 

• People who have experienced anaphylaxis before
• People with allergies to foods, insect stings, medicine and other triggers

If you are at-risk:

• Keep your epinephrine auto-injectors on-hand at all times and be ready to use them if an emergency occurs.
• Talk with your doctor about your triggers and your symptoms. Your doctor may tell you to see an allergist. An allergist can help you identify your allergies and learn to manage your risk of severe reactions.
• Ask your doctor for an anaphylaxis action plan. This will help you know what to do if you experience anaphylaxis.

Credit to www.aafp.org