숔크로 악화 될 수 있는 중증 앨러지란 어떤 것 ? 그 약물 요법은 ? > 임상 응용 정보

숔크로 악화 될 수 있는 중증 앨러지란 어떤 것 ? 그 약물 요법은 ?

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숔크로 악화 될 수 있는 중증 앨러지란 어떤 것 ? 
그 약물 요법은 ?</TD></TR>
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앨러지 중에는 중증 앨러지가 있다
 
중증 앨러지(Anaphylaxis) 환자는 
쇼크(Shock)로  악화되어 사망 까지도 하기 쉽다
 
따라서 중증 앨러지가 발생하면 
솤크 방지를 위한 응급 조치가 가장 급 선무이다
 
이는 하버드 의대 연구 팀의 연구 결과이며 
미국 앨러지 학회를 통해 발표한 내용 이ㅏㄷ
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잘 못돤 응급 조치 법들 </TD></TR>
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1993년부터 -2003년 사이에 미국 전역에서 발생한 
앨러지 응급 환자 1,000만 명에 대하여
응급 조치한 약물 요법 내역은 다음과 같다
 
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중증 앨러지 환자 1,000만 명에 대한
약물 사용 빈도</TD></TR>
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1993년</TD>
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2003년</TD></TR>
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항 히스타민 주</TD>
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59%</TD>
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62%</TD></TR>
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부신 피질호르몬 주</TD>
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22%</TD>
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45%</TD></TR>
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H2-차단제 주</TD>
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7%</TD>
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15%</TD></TR>
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Epinephrine(1mg/mL) 주</TD>
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11%</TD></TR>
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기관지확장제(흡입)</TD>
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3.3%</TD></TR></TBODY></TABLE>
 
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숔크 일으키기 전 브터 
무조건 Epinephrine 1mg/ml 주를 먼저 주사</TD></TR>
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병원 응급실로 찾아 든 앨러지 환자는
어느 순간 솤크를 일으킬지 모르는 환자들이다 
 
숔크를 일으키지 않은 상태에서 
무조건 Epinephrine 1mg/ml 주를 먼저 주사해야 한다
 
그럼에도 불구하고 숔크 예방에 가장 약한 
한 항히스타민제가 가장 많이 사용되어 왔다</TD></TR></TBODY></TABLE>
 
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중증 앨러지 (Anaphylaxis) 란 ?</TD></TR>
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신체 부위 두 곳 이상에서 
앨러지 반응을 일으킨 상태를 말한다
 
예를 들면 
두드러기와 맥박 증가라든가
두드러기와 호흡 곤란 등을 말한다</TD></TR></TBODY></TABLE>
 
 
 
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Shock 란 ?</TD></TR>
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중증 앨러지 상태가 최악으로 악화된 상태다
 
목이 부어올라 숨이 막히거나
수축기 혈압이 80 이하로 낮아져서 
심장 혈류가 감소하여 의식을 잃는 상태를 말한다
 
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Epinephrine 주가 왜 최상인가?</TD></TR>
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앨러지 상태를 치료하는 
 
-항 히스타민제의 작용을 발휘하며
 
-부신 피질 호르몬제의 작용도 발휘하며
 
-기관지 확장제 작용도 발휘하며
 
-심장 박동 촉진 작용도 발휘하며
 
-모든 생리 현상에 활기를 불어 넣는 작용을 발휘하기 때문이다
 
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가정용 주사를 처방하라</TD></TR>
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한번 중증 앨러지를 일으킨 자는
언젠가는 또다시 중증 앨러지를 일으킨다
 
 
앨러지 증조가 나타나면 
즉시 Epinephrine(0.3mg/mL) 을 자가 주사 할 수 있도록
주사 법을 가리켜 주고 비치 용으로 처방 해 주어야 한다
솤크 발생 전에 주사 해야 하기 때문이다</TD></TR></TBODY></TABLE>
 
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앨러지 발생에서 솤크 발생시까지</TD></TR>
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갑자는 수 분 내에 숔크를 발생한다
을자는 1-2 시간 내에 숔크를 발생한다
정자는 24 시간 내에 숔크를 발생한다
중상이 가라앉았다가 몇 시간 후에 숔크를 일으키는 자도 있다
 
따라서 중증 앨러지가 발생하면
즉시 Epinephrine 을 주사해야 하며
24시간 동안은 상태를 관망해야 한다</TD></TR></TBODY></TABLE>
 
 
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근거</TD>
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March 7, 2006 , American Academy of Allergy, Asthma & Immunology 
62nd Annual Meeting; Medscape Conference Coverage, based on 
selected sessions at Miami Beach, Florida; Epinephrine Underused in 
Emergency Anaphylaxis Treatment; Carlos A Camargo, Jr. MD DrPH,
Professor of Medicine and Epidemiology at Harvard Medical School
 
 
May God bless you!
전성수</TD></TR></TBODY></TABLE>