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"Anaphylaxis is a severe and sudden allergic reaction when a person is exposed to an allergen. The most common allergens are eggs, peanuts, tree nuts (e.g. cashews), cow's milk, fish and shellfish, wheat, soy, certain insect stings and medications."

 
 
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Active Inhaler - Puffer Sports Pouch

Active Inhaler - Puffer Sports Pouch 
A safe, comfortable & easy way of carrying your Asthma inhaler or other medications with you during sporting activity; or any time!
 
  • Can be worn as leg band, arm band or on any waist belt
  • Made of neoprene with a safe overlap closure
  • Easy grip elasticized Velcro strap
  • Specially designed for running, cycling, football and other sporting activities but it’s also just a great way to ensure that your inhaler is always on you
 
Asthma Inhaler Pouch on arm
Asthma Sports Case
 

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FEATURE ARTICLE: The Association Between Anaphylaxis and Asthma


Numerous publications have documented the association between anaphylactic reactions and asthma. Sampson, Mendelson and Rosen, who described 13 cases of anaphylaxis and compared 6 deaths and 7 near deaths, first noted this association in 1992. They concluded that asthma promoted more difficult anaphylactic reactions. In 1996 Ewan described 62 patients with anaphylaxis, 76% of whom had asthma.


In 2001, Bock SA, Munoz-Furlong A, and Sampson HA examined 32 cases of fatal anaphylaxis, mostly from peanut, and found that where complete information was available, 24 of 25 patients had asthma These authors concluded that there is a close association between asthma and fatal anaphylaxis. They called for further studies to determine " whether the food-allergic reaction triggers asthma symptoms and to determine whether this makes treating the episode more difficult".


A lower association between asthma and anaphylaxis was reported by Brown, McKinnon and Chu who reported that 23% of cases of anaphylaxis presenting to an emergency room in Australia were associated with asthma. While this is a lower percent relationship than described by the other investigators cited, it is still three times higher than the prevalence of asthma in adults in eastern Australia. Moreover the commonest cause of anaphylaxis in that study was drugs, a sensitivity that is not necessarily associated with atopy. In contrast, Ewan's study consisted of cases selected for peanut and nut sensitivity which usually occurs in more atopic individuals who are very likely to have asthma.


In 2001, Wuthrich and Ballmer-Weber cited data from the UK registry of fatal anaphylactic reactions that indicated most deaths due to allergic reactions to foods were associated with respiratory symptoms and respiratory arrest. They suggested that asthmatics who are allergic to a food are at increased risk for anaphylaxis and respiratory involvement. Foods with "hidden" allergens and meals at restaurants were considered particularly dangerous for patients with food allergies. Schools, public places and restaurants were the major places of risk. The main factor contributing to a fatal outcome was the victim's failure to carry their emergency kit with adrenaline (e.g. EpiPen®).


Gowland suggested that teenagers were a group who were at particular risk for serious anaphylaxis when they were atopic, had asthma and were known to be sensitized to a food. Teenagers tend to eat away from home and often fail to carry epinephrine.


In a small study of reactions to food in children (Zimmerman and Urch 2001). Ninety-six patients who were skin test positive to peanut returned for re-assessment a few years later. Ten of them had lost the positive skin test to peanut and successfully underwent oral challenge in a clinical setting without reacting. Of the 86 patients who retained the positive skin test to peanut, 26 had a total of 41 further reactions to food: 7 reacted to peanut, 6 with respiratory symptoms. Overall twenty-one of the reactions were associated with some form of respiratory symptoms but in only 6 instances (29%) was the EpiPen® used. That is despite the fact that we taught all children with a positive skin test to peanut, and/or their parents, how to use the EpiPen®. All but one of the 26 children had asthma and we had taught that at the first sign of a reaction, children with asthma should receive adrenaline (EpiPen®) and be taken to an emergency department. The data suggested that teaching and prescribing EpiPens® to peanut allergic patients does not guarantee the appropriate administration of epinephrine.


How important is proactive management of asthma to those who have severe food allergies? It is possible that the asthmatic child might be more at risk for reactions to foods that target the chest. Asthma is due to eosinophilic inflammation in the airways and allergy is a major mechanism for creating this inflammation. If allowed to continue untreated, this inflammation is thought to lead to remodelling of the airways thereby creating more sensitive air passages. This suggests that an allergic reaction to a food could interact with asthma in two ways. First the reaction by releasing mast cell mediators could induce immediate spasm and swelling of the airways with massive reduction in airflow in airways that are already twitchy. Secondly the allergic reaction could lead to a rapid influx of eosinophils from the circulation into the airways leading to a late allergic response in the airways. The Sampson study cited earlier, suggested that asthmatic children might be more prone to respiratory symptoms from a food-reaction and that the reaction might have a late-phase. Children need to be watched at least 4 hours before the rection should be considered to be over.


The literature suggests that children with asthma are at increased risk of a threatening reaction to food to which they are allergic, especially if the asthma is not fully controlled. This can occur when the asthma is underestimated and under-treated. We have published that children who are allergic to a pet in their home often seem to have mild intermittent asthma but when they are studied more fully, they are found to have chronic inflammation in the airways despite the apparent intermittent nature of their symptoms. As a result, such children are often under-treated for asthma and the pet is not removed from the home.


In summary, from the studies cited relating asthma to the severity of anaphylaxis, and the mechanisms outlined, it is important to manage asthma so that it is under control in the food-allergic patient. The Canadian Guidelines on managing asthma (www.asthmaguidelines.com), suggest that, after environmental control, inhaled steroid is the preferred treatment in all levels of asthma and that treatment should be sufficient to completely control the asthma. The medication may then be reduced to the minimum required to control symptoms. If you suspect that you or your child has asthma, consult your physician. Managing the asthma should give the best protection against respiratory symptoms if an asthmatic child reacts to a food.




Trust Activeaide to offer the most user friendly and highest quality Asthma consumer and protection products such as the Skinhaler (the clever puffer pouch) or Asthma inhaler sports pouch and protect your Anaphylaxis Auto-Injector such as EpiPen®, Anapen or Twinject with our great range of Original EpiPen® cases. All of the Activeaide products are designed in concert with hospital and medical specialists in Asthma and Anaphylaxis.