- Discontinue suspected drug.
(stop IV, tourniquet IM or subcut site.)
- Maintain airway.
Aminophylline or other bronchodilators may be required for severe respiratory distress.
- Administer epinephrine.
IM, Subcut (Adults): 0.3–0.5 mg, may repeat q 5–15 min
IM, Subcut (Children): 0.01 mg/kg, or 0.1 mg may repeat q 5–15 min
IV (Adults): 0.1 mg over 5 min or 1–4 mcg/min infusion
IV (Children): 0.01 mg/kg/dose or 0.1–0.2 mg over 5 min, may repeat q 30 min or 0.1–1.5 mcg (maximum)/kg/min infusion
- Administer antihistamines.
May prevent recurrence and decrease intensity of reaction.
IM, IV (Adults): 50–100 mg single dose, may follow with 50 mg every 6 hr for 1–2 days
IM, IV (Children): 5 mg/kg/day in divided doses q 6–8 hr (not to exceed 300 mg/day), may follow with oral therapy for 1–2 days
IV (Adults): 300 mg q 6 hr
IV (Children): 25–30 mg/kg/day in 6 divided doses
- Support blood pressure.
If necessary, use fluids and/or vasopressors. Patients receiving beta blockers may be resistant to the effects of vasopressers.
- Administer corticosteroids.
(may decrease intensity of reaction.)
IV (Adults and Children): 100–1000 mg, may follow with 7 mg/kg/day IV or oral therapy for 1–2 days.
- Document reaction.
in medical record, inform patient/family to carry identification.
Early Management of Anaphylactic Reactions was found in Davis's Drug Guide.
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