Recognition and Management of Anaphylaxis in Older Adults

To discuss medications that cause anaphylaxis in older adults and its treatment, with a focus on epinephrine.

A search of PubMed using the terms "anaphylaxis," "drug-induced anaphylaxis," "epinephrine autoinjectable," "anaphylaxis diagnosis," "anaphylaxis treatment," and "epinephrine cost" was performed. English-language articles from January 2000 to August 2016 appearing in these searches were reviewed.

Relevant review articles, consensus statements, practice parameters, task force recommendations, and original articles were assessed for recognition and treatment of drug-induced anaphylaxis.

Anaphylaxis is a serious allergic reaction that occurs with food, insect stings, latex, radio contrast agents, and medications. Medications that are commonly used by older adults can cause anaphylaxis. Epinephrine remains the first-line treatment option and does not have any contraindications.

Early recognition of drug-induced anaphylaxis symptoms is critical and medication should be administered immediately to prevent cardiac arrest. Additionally, health care providers can provide others with education on administration of epinephrine auto-injectable agents, availability of alternative options, and patient-assistance programs to lower the cost of epinephrine agents.