Jurnal Syok Anafilaktik Pdf 27
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An Overview of Anaphylactic Shock: Causes, Symptoms, and Treatment
Anaphylactic shock, also known as anaphylaxis, is a severe and potentially life-threatening allergic reaction that occurs when a person is exposed to an allergen or a trigger substance. Anaphylaxis is a type of hypersensitivity reaction that involves the release of histamine, serotonin, tryptase, and other vasoactive substances from basophils and mast cells. These substances cause widespread vasodilation, increased vascular permeability, bronchoconstriction, and smooth muscle contraction, leading to symptoms such as itching, hives, swelling, difficulty breathing, low blood pressure, fainting, and cardiac arrest.
Anaphylaxis can be caused by various substances, such as foods, drugs, insect stings, latex, and blood products. The most common causes of anaphylaxis are peanuts, shellfish, eggs, milk, penicillin, aspirin, muscle relaxants, contrast media, and latex. The onset of symptoms can range from minutes to hours after exposure to the allergen. The severity of the reaction can vary from mild to fatal, depending on the dose of the allergen, the route of exposure, and the individual's sensitivity.
The diagnosis of anaphylaxis is based on clinical criteria that include the presence of skin or mucosal involvement (such as hives or angioedema), respiratory compromise (such as wheezing or stridor), hypotension or shock (such as syncope or collapse), and involvement of other organ systems (such as gastrointestinal or neurological symptoms). Laboratory tests such as serum tryptase levels or skin prick tests can support the diagnosis but are not essential. The differential diagnosis of anaphylaxis includes other causes of shock, such as septic shock, cardiogenic shock, neurogenic shock, or hemorrhagic shock.
The treatment of anaphylaxis is aimed at reversing the effects of the mediators and preventing further release of them. The first and most important step is to remove the source of the allergen if possible and to administer epinephrine intramuscularly or intravenously. Epinephrine is the drug of choice for anaphylaxis because it has alpha-adrenergic effects that increase blood pressure and reduce edema, beta-adrenergic effects that relax bronchial smooth muscle and increase heart rate and contractility, and inhibitory effects on mast cell degranulation. The dose of epinephrine is 0.01 mg/kg (up to 0.5 mg) for adults and 0.01 mg/kg (up to 0.3 mg) for children every 5 to 15 minutes as needed.
Other adjunctive treatments for anaphylaxis include oxygen therapy, fluid resuscitation, antihistamines (such as diphenhydramine or cetirizine), corticosteroids (such as hydrocortisone or methylprednisolone), bronchodilators (such as albuterol or salbutamol), and vasopressors (such as dopamine or norepinephrine) for refractory hypotension. Patients with anaphylaxis should be monitored closely for signs of deterioration or recurrence and should be transferred to a hospital for further evaluation and management. Patients with a history of anaphylaxis should be educated about their condition and provided with an epinephrine auto-injector and a medical alert bracelet or necklace.
Anaphylactic shock is a serious medical emergency that requires prompt recognition and treatment. By understanding the causes, symptoms, and treatment of anaphylaxis, health care professionals can help save lives and prevent complications. 248dff8e21