Understanding drug anaphylactic shock: A narrative review on its recognition and first aid strategies

Abstract

Drug allergies are the most common cause of fatal anaphylaxis and a public health problem that plagues every clinician. Based on the actual situation of clinical nursing, the author consulted the latest guidelines, expert consensus, literature, etc., and summarized and analyzed the definition, diagnostic criteria, and mechanism of drug anaphylaxis/anaphylactic shock; common allergic drugs and their routes of administration; the fourth-grade symptoms of drug allergic reactions; the manifestations and outcomes of anaphylactic shock; and the first aid of drug anaphylaxis, such as the application timing, route, dosage, and precautions of first- and second-line rescue drugs and other auxiliary first aid measures. The importance of effectively preventing anaphylaxis/anaphylactic shock from the perspective of understanding the patient's allergy history before medication, conducting drug allergy testing according to norms, prohibiting the use of drugs with clear allergies, and strengthening post-medication evaluation. It has been proposed that the rapid identification of the manifestations of various drug-induced anaphylactic shock systems and the precise use of epinephrine are key to the success of first aid. The goal of this narrative review was to synthesize the current evidence on drug anaphylactic shock recognition and first-aid strategies. By consolidating clinical guidelines, pharmacological protocols, and expert consensus, this review aimed to enhance medical personnel's vigilance and intervention efficacy, particularly among junior healthcare providers, in managing drug-induced anaphylaxis.