_LOCAL FIRST AID:_
1. Repeated stripping using adhesive or cellophane tape to remove
spines
2. Apply ice packs
3. Apply baking soda and water paste
_SYSTEMIC:_
1. For severe pain give meperidine hydrochloride (Demerol, 50-100 mg
PO or IM), morphine sulfate (0.25 subcutaneous), codeine
phosphate (0.5 g PO)
NOTE: Aspirin is generally not effective
2. Shock (Chart 2)
CHART 1
ANTIHISTAMINES
GROUP TRADE NAME AVERAGE ORAL BASE SEDATION
GENERIC NAMES ADULT CHILD
Ethanolamines
diphenhydramine•HCl Benadryl 50 mg q 4-6h 25 mg q 4-6h ++++
diphenhydramine Dramamine 50 mg q 4h 25 mg q 4h ++++
theophyllinate
Ethylenediamine
tripelennamine Pyribenzamine 50 mg q 4-6h 25 mg q 4-6h +++
Alkylamines
chlorpheniramine maleate Chlor-Trimeton 4 mg q 6h 2 mg q 6h ++
brompheniramine maleate Dimetane 8 mg q 6h 4 mg q 6h +
triprolidine•HCl Actidil 2.5 mg q 8h 1.25 mg q 8h ++
Cyclizines
hydroxyzine•HCl Atarax 25-100 mg q 10-25 mg q +
6h 6h
Miscellaneous
cyproheptadine•HCl Periactin 4 mg q 6h 2 mg q 6h +++
promethazine Phenergan 25-50 mg q 12.5-25 mg ++++
6-8h q 6-8h
Chart 2
Treatment of Anaphylaxis—Shock
IMMEDIATE TREATMENT MILD REACTION TREATMENT SEVERE REACTION TREATMENT
REACTION: Conjunctivitis, Rhinitis, Urticaria, Pruritus, Erythema
Epinephrine•HCl 0.3 ml Diphenhydramine•HCl 50 mg
(1:1,000) IM PO q 6h
Diphenhydramine•HCl 50 mg
PO