Adverse Reactions & Pharmacovigilance

Anaphylaxis

TRAnafilaksi
Also known as:Anaphylactic reaction

A severe, potentially life-threatening systemic hypersensitivity reaction of rapid onset that causes airway, breathing or circulatory compromise, usually but not always with skin or mucosal changes.

In depth

Anaphylaxis results from sudden release of mast-cell and basophil mediators such as histamine, tryptase and leukotrienes, producing vasodilatation, increased vascular permeability, bronchoconstriction and angioedema. Drug-induced cases may be IgE-mediated (e.g., beta-lactams, neuromuscular blocking agents) or non-IgE-mediated through direct mast-cell activation (e.g., radiocontrast media, some opioids); the older term anaphylactoid is no longer recommended.

Intramuscular adrenaline (epinephrine) into the anterolateral thigh is first-line treatment, supported by airway management, high-flow oxygen and intravenous fluids; antihistamines and glucocorticoids are adjuncts only. A serum tryptase measured shortly after onset supports the diagnosis, and a biphasic reaction may follow hours later.

Clinical pearl

Give intramuscular adrenaline without delay: it is the only first-line drug. Patients taking beta-blockers may respond poorly and may need glucagon.

Example drugs

Benzylpenicillin Cefazolin Rocuronium suxamethonium Diclofenac
TRIn Turkish

Anafilaksi

Hızlı başlayan, hava yolu, solunum veya dolaşımda bozulmaya yol açan, genellikle (ancak her zaman değil) deri ya da mukoza bulgularının eşlik ettiği, yaşamı tehdit edebilen ağır sistemik aşırı duyarlılık reaksiyonudur.

Anafilaksi; histamin, triptaz ve lökotrienler gibi mast hücresi ve bazofil mediyatörlerinin ani salınımı sonucu vazodilatasyon, damar geçirgenliğinde artış, bronkokonstriksiyon ve anjiyoödemle ortaya çıkar. İlaca bağlı olgular IgE aracılı (ör. beta-laktamlar, nöromüsküler blokörler) ya da doğrudan mast hücresi aktivasyonu yoluyla IgE aracılı olmayan (ör. radyokontrast maddeler, bazı opioidler) mekanizmalarla gelişebilir; eski anafilaktoid terimi artık önerilmemektedir.

Birinci basamak tedavi, uyluğun anterolateral yüzüne intramüsküler adrenalindir (epinefrin); buna hava yolu yönetimi, yüksek akımlı oksijen ve intravenöz sıvı desteği eşlik eder, antihistaminikler ve glukokortikoidler yalnızca yardımcı tedavidir. Başlangıçtan kısa süre sonra ölçülen serum triptaz düzeyi tanıyı destekler; saatler sonra bifazik reaksiyon gelişebilir.

İntramüsküler adrenalin gecikmeden uygulanmalıdır; birinci basamakta kullanılan tek ilaçtır. Beta blokör kullanan hastalarda yanıt zayıf olabilir ve glukagon gerekebilir.

Diğer adları:Anafilaktik reaksiyon
Updated 24.09.2026 1 views Educational reference — verify against current sources before clinical use.

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