steroids in anaphylactic shock
Steroids in anaphylactic shock
- routine use of corticosteroids to treat anaphylaxis is not advised
- consider giving steroids after initial resuscitation for refractory reactions or ongoing asthma/shock
Steroids must not be given preferentially to adrenaline (1):
- primary action of corticosteroids is the downregulation of the late-phase (rather than early-phase) inflammatory response. However, there is little evidence that corticosteroids help shorten protracted symptoms or prevent biphasic reactions
- are emerging data suggesting that early use of steroids is associated with an increased risk of intensive care admission, even after adjusting for severity of presenting symptoms
- in asthma, early corticosteroid treatment may be beneficial in adults and children
- corticosteroids may be indicated where an acute asthma exacerbation may have contributed to the severity of anaphylaxis
- steroids should be given by the oral route where possible
- refer to the BNF for Children to find information on appropriate dosing
Reference:
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