Anaphylaxis
A severe, potentially life-threatening allergic reaction occurring rapidly after drug exposure, involving multiple organ systems. Anaphylaxis requires immediate treatment with epinephrine and is a known risk with any injectable biologic product. First injections of peptide drugs may be administered in supervised settings.
Technical Context
Anaphylaxis diagnostic criteria (Sampson 2006): acute onset (minutes to hours) with involvement of skin/mucosal tissue (urticaria, flushing, angioedema) PLUS either respiratory compromise (dyspnoea, wheeze, bronchospasm, stridor) OR cardiovascular compromise (hypotension, syncope, end-organ dysfunction). Treatment: epinephrine (adrenaline) IM injection into anterolateral thigh (adult 0.5mg, child 0.01mg/kg — first-line, should be given immediately), position patient supine with legs elevated, establish IV access, administer IV fluids for hypotension, nebulised salbutamol for bronchospasm, and antihistamines/corticosteroids as adjuncts. For peptide drugs administered in healthcare settings, anaphylaxis management equipment must be immediately available. Post-anaphylaxis: the triggering peptide drug is generally contraindicated for future use, though desensitisation protocols exist for essential medications without alternatives.