From: Epinephrine: The Drug of Choice for Anaphylaxis--A Statement of the World Allergy Organization
I. General measures |
   Obtain thorough history to diagnose life-threatening food or drug allergy |
   Identify cause of anaphylaxis and those individuals at risk for future attacks |
   Provide instruction on proper reading of food and medication labels, where appropriate |
   Avoidance of exposure to antigens and cross-reactive substances |
   Optimal management of asthma and coronary artery disease |
   Implement a waiting period of 20 to 30 min after injections of drugs or other biologic agents |
   In the physician's office, consider a waiting period of 2 h if a patient receives an oral medication he/she has never previously taken |
II. Specific measures for high-risk patients |
   Individuals at high risk for anaphylaxis should carry self-injectable syringes of epinephrine at all times and receive instruction on proper use with placebo trainer |
   MedicAlert (MedicAlert Foundation, Turlock, Calif) or similar warning bracelets or chains |
   Substitute other agents for β-adrenergic blockers, angiotensin-converting enzyme inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors, whenever possible |
   Agents suspected of causing anaphylaxis should be given orally if possible; if the intravenous route is needed, a slow supervised rate of administration is required |
   Where appropriate, use specific preventive strategies, including pharmacological prophylaxis, short-term challenge and desensitization, and long-term desensitization |