Immediate hypersensitivity reactions


DRUG RELATED ANAPHYLAXIS

T88.6

See Anaphylaxis/anaphylactic reactions .

DRUG RELATED URTICARIA

L50.9

See Dermatology See Urticaria .

DRUG RELATED ANGIOEDEMA

T78.3

DESCRIPTION

Local swelling of skin and/or mucosal tissue. May occur in isolation or together with urticaria or anaphylaxis. It must be distinguished from recurrent non-pruritic angioedema which has a hereditary component and does not respond to the treatment below. Complement C4 and C1 esterase inhibitor levels are used to help to distinguish the two entities.

GENERAL AND SUPPORTIVE MEASURES

  • Stop potentially causative drug(s).
  • Monitor airway closely and intubate early if necessary.

MEDICINE TREATMENT

If symptoms and signs of anaphylaxis: treat as for anaphylaxis, see Anaphylaxis/anaphylactic reactions .

If angioedema in isolation:

  • Chlorphenamine, oral, 0.1 mg/kg/dose 6 hourly.

AND

  • Prednisone, oral, 1–2 mg/kg daily for 1 week.

OR

If unable to take oral and ≥ 2 years:

  • Promethazine, IM, 0.5 mg/kg immediately, followed by above oral therapy.

LoEIII [1]

REFERRAL

  • All cases after stabilisation for confirmation of diagnosis and long-term management.
  • Recurrent non-pruritic angioedema.