Action
Allergic Reaction Treatment
- Give H1 and H2 blockers (Class III)
Class | Name | Adult Dosing | Pediatric Dosing |
H1 blockers, first generation | Diphenhydramine | 25-50 mg IV, IM, PO every 6-8 hr | 1 mg/kg (max 50 mg/dose) IV, IM, PO |
Hydroxyzine HCl | 25 mg PO daily to tid | ≤40 kg: 2 mg/kg/day (max 25 mg/dose) PO divided every 6-8 hr
>40 kg: 25 mg PO daily/bid | |
H1 blockers, second generation | Cetirizine | 10 mg IV, PO daily | Age 6 mo to <12 mo: 2.5 mg PO, IV daily
Age 12 mo to <6 yr: 2.5-5 mg PO, IV daily
Age 6-12 yr: 5-10 mg PO, IV daily
Age ≥12 yr: 10 mg PO, IV daily |
Loratadine | 10 mg PO daily | Age 2-6 yr: 5 mg PO daily
Age ≥6 yr: 10 mg PO daily | |
H2 blockers | Cimetidine | 300 mg PO every 6 hr | 10 mg/kg (max 300 mg/dose) PO every 6 hours |
Famotidine | 20 mg PO, IV bid | 0.5 mg/kg (max 20 mg/dose) PO, IV, bid |
- +/- Corticosteroids (Class III)
Drug | Adult Dosing | Pediatric Dosing |
Hydrocortisone | 250-500 mg IV | 5-10 mg/kg IV (max 500 mg) |
Methylprednisolone | 80-125 mg IV | 1-2 mg /kg IV (max 125 mg) |
Prednisone | 40-60 mg PO qd or bid for 3-5 days | 1-2 mg/kg PO qd or bid for 3-5 days |
- Monitor
Decision
Are symptoms resolving?
Yes
- Discharge home with autoinjector if patient given treatment for anaphylaxis
- Provide allergy referral when indicated (Class II)
