Allergic Reaction Drugs

- Steroid

- Description: Dexamethasone is a long-acting synthetic drenocorticoid with intense anti-inflammatory activity. It prevents the accumulation of inflammation generating cells at the site of infection or injury.

- Indications: Anaphalaxis, COPD, asthma, spinal cord edema.

• - Contraindications: NO absolute contraindications in the emergency setting.
• - Relative Contraindications: systemic fungal infections, acute infections, tuberculosus, vericella, or vaccinia, or live virus vaccinations.

- Precautions: Herpes simplex, keratitis, myasthenia gravis, hepatic or renal impairment, diabetes, CHF, seizures, psychotic disorders, hyperthyroidism, and GI ulceration

• - Dosage/Route: 4 to 24 mg IV/IM
• - Pedi: 0.5 to 1.0 mg/kg

- Antihistamine

- Description: Diphenhydramine blocks histamine release, thereby reducing bronchoconstriction, vasodilation, and edema.

- Indications: Anaphalaxis, Allergic reactions, and distoric reactions

- Contraindications: Asthma or other lower respiratory diseases.

- Precautions: May induce hypotension, headache, palpitations, tachycardia, sedation, drowsiness, and/or disturbed coordination.

• - Dosage/Route: 25 to 50 mg IV/IM
• - Pedi: 2 to 5 mg/kg

- Corticosteroid/Anti-inflammatory

- Description: Methylprednisolone is a synthetic adrenal corticosteroid, effective as an anti-inflammatory and used in the management of allergic reactions and in some cases of shock. It is sometimes used in the treatment of spinal cord injury.

- Indications: Spinal cord injury, asthma, severe anaphalaxis, COPD

- Contraindications: No absolute contraindications in the emergency setting.

- Precautions: Only a single dose should be given in the prehospital setting

• - Dosage/Route: Asthma/COPD/Anaphalaxis: 125 to 250 mg IV/IM
• - Pedi: 1 to 2 mg/kg/dose IV/IM
• - Spinal Cord Injury: 30 mg/kg over 15 minutes

- Sympathomimetic

- Description: Epinephrine is a naturally occuring catecholamine that increases heart rate, cardiac contractile force, myocardial electrical activity, systemic vascular resistance, and systolic blood pressure and decreases overall airway resistance and automaticity.

- Indications: To restore rhythm in cardiac arrest, and severe allergic reactions

- Contraindications: Narrow angle glaucoma, hemorrhagic, traumatic, or cardiac shock

• - Dosage/Route: Arrest: 1 mg of 1:10,000 IV/3 to 5 mins (ET 2 to 2.5 mg 1:1,000)
• - Pedi: 0.01 mg/kg of 1:10,000 IV/IO (ET 0.1 mg/kg 1:1,000) All subsequent doses 0.1 mg/kg IV/IO. no max
• - Adult Bradycardia: 2 to 5 mcg/min (IV drip)
• - Allergic Reactions: 0.3 to 0.5 mg of 1:1,000 subcutaneously/5 to 15 mins as needed or 0.5 to 1 mg 1:10,000 IV if subcutaneous ineffective or severe reaction.
• - Pedi: 0.01 mg/kg (Max 0.5) of 1:1,000 SQ/10 to 15 mins or 0.01 mg/kg of 1:10,000 IV if subcutaneous dose ineffective or severe
• - Asthma/COPD: 0.3 mg 1:1,000 SQ