Anaphylaxis

Anaphylaxis

:life-threatening allergic reaction.

Rx:
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-Epinephrine IMI: (on anterolateral thigh rather than deltoid or buttock)
(epinephrine 1:1000 -> 1mg/ml)
Adult: 0.3 ~ 0.5 mg IMI every 5~15 min
Child: 0.01 mg/kg <max 0.3 mg>
(add 1ml of 1:1000 epinephrine to 9 ml sterile water then give 0.1 ml /kg of the mixed solution)

-IV normal saline

+- intubation / cricothyroidotomy

-Inhaled beta-2 agonist. Adult: sabultamol inhaled  5 mg every 20 min.


Adjunct therapy - Antihistamine & corticosteroids
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Antihistamines relieve itching & hives but has no effect on severe symptoms such as
airway obstruction and shock.
H1 and H2 antihistamine in combination are more effective in palliating the skin allergy.

( diphenhydrajmine 1 mg/kg IM/IVI  Adult: 50 mg
ranitidine 1 mg/kg IVI over 5 min Adult: 50 mg )


Corticosteroids have slow onset of action. It has no effect for 4 to 6 hrs even when given IVI.
Used as preventative treatment after stabilization.

(predisolone 1 mg/kg/day orally)