Anaphylactic Reaction may occur to :

Drugs: Penicillin, Streptomycin, Vit B1, Imferon, Xylocaine.

Serum Injections: Anti-Tetanus Serum, Anti-Diptheria Serum, Anti-snake venom.

Iodine containing dyesused for I.V.P, CT scan, Myelogram.

All above injections must b given After Test Dose.

Suspect Anaphylaxis if :  After injection, patient complains of Giddiness, nausea, urticaria, dyspnoea, restlessness and falls down or has thready pulse and low B.P.

Treatment:

1. Make the patint horizontal immediately, on ground or bed.
2. Inj. Adrenalin 0.5-1ml Subcut. (Repeat SOS after 10 mins)
3. Inj.  Avil 2cc IM or I.V. (Antihistaminic = 5B-1)
4. Inj. Efcorlin 100mg x 1-2 vials I.V. (Hydrocortisone = 9A-5) or inj. BETNESOL 8mg x 1-2 amps I.V.V (Betamthasone = 9A-3) or inj. Decardon 2 cc x 1-2 vials I.V. (Dexamethasone = 9A-2)
5. If B.P. has fallen:

Inj. Mephentin 2cc I.V. stat.

I.V. DNS/RL fast.

6.  Watch pulse, BP & Respiration, till the patient recovers                                         completely.

Warnings:

1. Always keep emergency Drugs at hand in you clinic an din your home visit bag.
2. Always be alert and prepared to treat anaphylaxis – even after a test dose and even in a patient who has received the injection before.
3. Act boldly & confidently.
4. Always give a test dose for the drugs known to cause anaphylaxis.

0.1ml intradermal

- Penicillin, streptomycin, Bplex, Xylocaine & serum Injections.

0.5ml intramuscular

- For Imferon.

How to give a test dose?

With a Insulin/1cc Syringe and 26 NO. Needle, inject 0.1ml of the drug intradermally. Mark the site of Injection with a ball pen and let the patient sit in the waiting room for half hour. If there is indurated wheel at the site of Injection, or urticaria & itching or patient feels giddy, then do not give the injection – use an alternate drug.

In case of anaphylaxis, Make the patient horizontal, Give Inj adrenalin 0.5ml Subcut, followed by Avil and Efcorlin IM. If reaction is severe , give Avil & Efcorlin I.V. x 2 amps each and start a fast I.V. drip

Penicillin, Streptomycin, Vit B1, Imferon, Xylocaine

Inj. Adrenalin

inj. Decardon