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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.


  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.


  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




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