What management strategies should I consider for a patient experiencing an anaphylactic reaction to a medication?

Management strategies for a patient experiencing an anaphylactic reaction to a medication include:

• Immediate emergency treatment with intramuscular adrenaline as first-line therapy.
• Document the acute clinical features of the reaction, including airway, breathing, circulation involvement, and skin/mucosal changes, and record the time of onset and circumstances before symptoms to help identify the trigger.
• Take timed blood samples for mast cell tryptase testing as soon as possible after emergency treatment and a second sample within 1 to 2 hours (no later than 4 hours) from symptom onset to support diagnosis.
• Observe adults and young people (≥16 years) for 6 to 12 hours from symptom onset depending on response to treatment; children (<16 years) should be admitted under paediatric care.
• Before discharge, provide the patient (or their carer) with detailed information about anaphylaxis, including signs and symptoms, risk of biphasic reactions, and instructions on adrenaline injector use with a brand-specific demonstration.
• Prescribe two additional adrenaline injectors and advise carrying them at all times.
• Advise on avoidance of the suspected medication trigger and provide information about referral to a specialist allergy service for further investigation, diagnosis, monitoring, and ongoing management.
• Refer patients who have had anaphylaxis due to medication to a specialist drug allergy service, especially if the reaction was severe or if future treatment with the implicated drug class is necessary.