Something is still wrong: Epinephrine use in venom immunotherapy patients
Abstract
Backgrounds: Anaphylaxis is hard to recognize and, therefore, a poorly treated systemic allergic reaction. The aim of the treatment in anaphylaxis is to prevent the progression of the clinical picture to life-threatening respiratory and/or cardiovascular symptoms and signs through early diagnosis of anaphylaxis and administration of adrenaline.
Methods: Seventy-eight patients [(Female (F): 22 (28.2%), Male (M): 56 (71.8%)] who received venom immunotherapy were included in this study. A mini questionnaire was applied to these patients about in which situation they should use the adrenaline auto-injector (AAI), what to do after using AAI, and how to use it.
Results: Thirty-four patients (43.6%) were stung by a bee after initiation of immunotherapy while 16 patients (47.1%) developed urticaria/angioedema. Ten patients (29.4%) used AAI following a bee sting, whereas 24 patients (70.6%) didn’t use AAI. Fiftytwo (66.7%) patients correctly answered the four questions regarding what to do following administering AAI, in what cases and frequency they should have AAI prescribed, storage and transportation conditions of AAI, and how to administer AAI. Among the patients who were stung by a bee during immunotherapy, the rate of answering all questions correctly of the patients who administered AAI during anaphylaxis was determined to be significantly higher (p=0.001).
Conclusions: Although adrenaline treatment is the most vital method of treatment in anaphylaxis, patients still do not have a sufficient level of awareness on the importance and vitalness of adrenaline treatment. It is very important to train patients at risk and patient relatives primarily by physicians at appropriate intervals.
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