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Allergic Reactions Allergic reactions are sensitivities to substances, called allergens that are contacted through the skin, inhaled into the lungs, swallowed, or injected. Allergic reactions are common. The immune response that causes an allergic reaction is similar to the response that causes hay fever. Most reactions happen soon after contact with an allergen. Many allergic reactions are mild, while others can be severe and life-threatening. They occur more often in people with a family history of allergies. Substances that don't bother most people (such as venom from bee stings, certain foods, medications, and pollens) can trigger allergic reactions in certain people. While first-time exposure may only produce a mild reaction, repeated exposures may lead to more serious reactions. Once a person has had an allergic reaction (is sensitized), even a very limited exposure to a very small amount of allergen can trigger a severe reaction. Allergic reactions can be mild or serious. They can be confined to a small area of the body or may affect the entire body. Most severe allergic reactions occur within seconds or minutes after exposure to the allergen. However, some reactions can occur after several hours, particularly if the allergen causes a reaction after it has been ingested. In very rare cases, reactions develop after 24 hours. Anaphylaxis is a sudden and severe allergic reaction that occurs within minutes of exposure. Immediate medical attention is needed for this condition. It can get worse very fast and lead to death within 15 minutes if treatment is not received.
• Animal dander • Bee stings or stings from other insects, insect bites • Foods, especially nuts, fish, and shellfish • Medications • Plants or pollens
Common symptoms of a mild allergic reaction include:
• Hives (especially over the neck and face), rashes, itching • Nasal congestion, watery, red eyes
Symptoms of a moderate or severe reaction include:
• Cramps or abdominal pain • Chest discomfort or tightness • Difficulty breathing, wheezing and swallowing • Weakness, dizziness/lightheadedness • Fear or feeling of apprehension or anxiety • Flushing/redness of the face, swelling of the face, eyes, or tongue • Nausea, vomiting and diarrhea • Unconsciousness
1. Calm and reassure the person having the reaction, as anxiety can worsen
2. Try to identify the allergen and have the person avoid further contact with it. If
the allergic reaction is from a bee sting, scrape the stinger off the skin with something firm (such as a fingernail or plastic credit card). Do not use tweezers; squeezing the stinger will release more venom.
3. If the person develops an itchy rash, apply calamine lotion and cool compresses.
You may also apply over-the-counter cortisone cream.
4. Watch the person for signs of increasing distress. 5. Get medical help. For a mild reaction, a physician may recommend over-the-
counter medications (such as antihistamines).
For a severe allergic reaction (anaphylaxis):
1. Check the person's airway, breathing, and circulation. A warning sign of
dangerous throat swelling is a very hoarse or whispered voice, or coarse sounds when the person is breathing air in. If necessary, begin rescue breathing/CPR.
2. Call 911. 3. Calm and reassure the person. 4. If the allergic reaction is from a bee sting, scrape the stinger off the skin with
something firm (such as a fingernail or plastic credit card). Do not use tweezers -- squeezing the stinger will release more venom.
5. If the person has emergency allergy medication on hand, help the person take or
inject the medication. Avoid oral medication if the person is having difficulty breathing.
6. Take steps to prevent shock. Have the person lie flat, raise the person's feet
about 12 inches, and cover him or her with a coat or blanket. Do NOT place the person in this position if a head/neck/back, or leg injury is suspected or if it causes discomfort.
• Do NOT assume that any allergy shots the person has already received will
• Do NOT place a pillow under the person’s head if he or she is having trouble
• Do NOT give the person anything by mouth if the person is having trouble
Call for immediate medical emergency assistance if:
• The person is having a severe allergic reaction, always call 911. Do not wait to
• The person has a history of severe allergic reactions (check for a medical ID
• Avoid triggers such as foods and medications that have caused an allergic
reaction, even a mild one, in the past. This includes asking detailed questions about ingredients when you are eating away from home. Also carefully examine ingredient labels.
• If you have a child who is allergic to certain foods, introduce one new food at a
time in small amounts so you can recognize an allergic reaction.
• People who know that they have had serious allergic reactions should wear a
• If you have a history of serious allergic reactions, carry emergency medications
(such as diphenhydramine and injectable epinephrine or a bee sting kit) according to your health care providers instructions.
• Do not use your injectable epinephrine on anyone else. They may have a
condition (such as a heart problem) that could be negatively affected by this drug.
Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2008;121:S402-S407.
MEDICATION GUIDE PERTZYE (pert-zye) (pancrelipase) delayed-release capsules Read this Medication Guide before you start taking PERTZYE and each time you get a refill. There may be new information. This information does not take the place of talking to your doctor about your medical condition or treatment. What is the most important information I should know about PERTZYE?
Fellow of the American College of Gastroenterology Faculty Lecturer, Mount Sinai School of Medicine You are scheduled to have an endoscopy on ___________________ at ___________ AM/PM PLEASE MAKE SURE TO REVIEW THESE INSTRUCTIONS A WEEK BEFORE YOUR PROCEDURE! THE WEEK BEFORE YOUR ENDOSCOPY • Make sure to arrange for an escort for the day of the procedure. Discuss with Dr Gutman a