Life threatening severe allergic reaction  pruritis, urticaria, angioedema, hypotension, bronchospasm – occur within seconds to minutes of exposure to a specific antigen – Type 1 hypersensitivity reaction.
1 in 5000 exposures to parenteral penicillin or cephalosporin  anaphylaxis. Other common antigens that may trigger reaction include foods, additives, stings and bites.

If untreated  respiratory and vascular collapse  death within minutes to hours.

Clinical features:
90% have skin involvement – urticaria, erythema, pruritus.
Upper respiratory tract – nasal congestion, sneezing, cough, tightness
Bronchospasm  dyspnoea

Immediate subcutaneous epinephrine/adrenaline  vasodilation and bronchial smooth muscle relaxation; CPR if cardiac arrest; monitor for hypotension and shock

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