A practical guide to anaphylaxis

Am Fam Physician. 2003 Oct 1;68(7):1325-32.


Anaphylaxis is a life-threatening reaction with respiratory, cardiovascular, cutaneous, or gastrointestinal manifestations resulting from exposure to an offending agent, usually a food, insect sting, medication, or physical factor. It causes approximately 1,500 deaths in the United States annually. Occasionally, anaphylaxis can be confused with septic or other forms of shock, asthma, airway foreign body, panic attack, or other entities. Urinary and serum histamine levels and plasma tryptase levels drawn after onset of symptoms may assist in diagnosis. Prompt treatment of anaphylaxis is critical, with subcutaneous or intramuscular epinephrine and intravenous fluids remaining the mainstay of management. Adjunctive measures include airway protection, antihistamines, steroids, and beta agonists. Patients taking beta blockers may require additional measures. Patients should be observed for delayed or protracted anaphylaxis and instructed on how to initiate urgent treatment for future episodes.

Publication types

  • Review

MeSH terms

  • Allergens / adverse effects
  • Anaphylaxis / diagnosis
  • Anaphylaxis / etiology
  • Anaphylaxis / prevention & control*
  • Bronchodilator Agents / therapeutic use
  • Clinical Protocols
  • Desensitization, Immunologic / methods
  • Diagnosis, Differential
  • Drug Hypersensitivity / complications
  • Emergency Medical Services / methods
  • Epinephrine / therapeutic use
  • Food Hypersensitivity / complications
  • Histamine H1 Antagonists / therapeutic use
  • Humans
  • Insect Bites and Stings / complications


  • Allergens
  • Bronchodilator Agents
  • Histamine H1 Antagonists
  • Epinephrine