Medications for Allergic Reactions Flashcards
diphenhydramine hydrochloride (Benadryl)
An ANTIHISTAMINE that binds and blocks H1 histamine receptors, treating histamine-mediated symptoms of an allergic reaction.
diphenhydramine hydrochloride (Benadryl) Indications
Allergic reactions.
Dystonic medication reactions or akathisia (agitation or restlessness).
diphenhydramine hydrochloride (Benadryl) Adverse Effects
Drowsiness
Dizziness
Headache
Excitable State
Dry Mouth
Flushing
diphenhydramine hydrocholoride (Benadryl) Precautions
Acute asthma or COPD due to thickened secretions
Narrow-angle glaucoma.
diphenhydramine hydrochloride (Benadryl) Dosage and Administration
Adult: 50 mg IV/IM
Pediatric: 1 mg/kg slow IV/IM not to exceed 50 mg.
diphenhydramine hydrochloride (Benadryl) Special Considerations
CNS depressants and alcohol may have additive effects.
Anticholinergic and antiparkinsonian effects are used for treating dystonic reactions caused by antipsychotic and antiemetic medications (haloperidol, droperidol, reglan, compazine, etc.)
MAO inhibitors may prolong and intensify the anticholinergic effects of antihistamines.
Pregnancy class B.
epinephrine (Adrenalin)
An INOTROPIC ADRENERGIC endogenous catecholamine alpha and beta adrenergic receptor agonist.
epinephrine (Adrenalin) Indications
Pulseless Arrest
Anaphylaxis
Asthma
Bradycardia with poor perfusion
epinephrine (Adrenalin) Adverse Reactions
Tachycardia and tachydysrhythmia
Hypertension
Anxiety
Angina Pectoris
epinephrine (Adrenalin) Dosage and Administration
Adult: 0.3 (0.3 mL of 1:1000) IM. May repeat one time.
Pediatric: 0.01 mg/kg (0.01 mL/kg of 1:1000) IM. May repeat dose one time after 5 minutes.
epinephrine (Adrenalin) Vasopressor Infusion
Indications: Severe allergic reaction/Anaphylaxis.
Hypotension with poor perfusion refractory to adequate fluid resuscitation
Bradycardia with signs or poor perfusion.
Dosage and Administration: Inject 1 mg epinephrine into a 1000 mL normal saline bag to achieve 1 mcg/mL concentration.
(1 mL 1:1000 or 10 mL of 1:10,000 - either way, 1 mg of drug).
Titrate to desired hemodynamic effect with the goal blood pressure of greater than 90 systolic, improved respiratory status (bronchodilation), and improved perfusion/mentation.
Pregnancy Class C.
epinephrine (Adrenalin) Pediatric Severe Systemic Allergic Reaction refractory to IM epi
Dosage: 0.01 mg/kg (1 mL/kg of 1:100,000) IV.
1:100,000 = 1:10,000 - 9 mL + 9 mL normal saline.
methylprednisolone (Solu-Medrol)
A synthetic CORTICOSTEROID that suppresses acute and chronic inflammation and may alter the immune response. It potentiates vascular smooth muscle relaxation by beta-adrenergic agonists and may alter airway hyperactivity.
methylprednisolone (Solu-Medrol) Indications
Anaphylaxis
Severe Asthma
COPD
Suspected Addisonian Crisis (Cardiovascular collapse in patient at risk for adrenal insufficiency).
methylprednisolone (Solu-Medrol) Adverse Reactions
Gastrointestinal bleeding
Hypertension
Hyperglycemia
usually as a result of long-term therapy
methylprednisolone (Solu-Medrol) Dosage and Administration
Adult: 125 mg slow IV bolus over 2 minutes.
Pediatric: 2 mg/kg slow IV over 2 minutes. Max dose 125 mg.
methylprednisolone (Solu-Medrol) Special Considerations
Must be reconstituted and used immediately.
The effect is usually delayed for several hours.
Is not considered a first-line drug. Always attend to the patient’s primary treatment needs first.
Do not delay transport to administer this drug.
albuterol sulfate (Proventil)
A BETA AGONIST BRONCHODILATOR that binds and stimulates beta 2 receptors, resulting in relaxation of bronchial smooth muscle.
albuterol sulfate (Proventil) Indications
Asthma, bronchitis with bronchospasm, and COPD.
Known or suspected hyperkalemia with EKG changes (peaked T waves or QRS widening).
albuterol sulfate (Proventil) Contraindications
Sensitivity to albuterol or levalbuterol.
Severe tachycardia is a relative contraindication.
albuterol sulfate (Proventil) Adverse Effects
Tachycardia
Palpitations
Dysrhythmias
albuterol sulfate (Proventil) Drug Interactions
Sympathomimetics may exacerbate adverse cardiovascular effects. Beta-blockers may antagonize albuterol.
albuterol sulfate (Proventil) Dosage and Administration
Adult: 2.5 mg/3 mL at 6-8 liters per minute over 5 to 15 minutes. May be repeated one time.
Continuous Neb: 7.5 mg/9 mL (3 premixed bullets) at 6-8 liters per minute.
albuterol sulfate (Proventil) Special Considerations
Use with caution in lactating patients, those with cardiac dysrhythmias, suspected or known coronary disease, diabetes, hyperthyroidism, prostatic hypertrophy, or seizure disorder.
Angina Pectoris.
Wheezing associated with anaphylaxis should first be treated with epinephrine IM.
Consider inline nebs for patients requiring endotracheal intubation or CPAP.
Pregnancy Class C.
