From the Research
For anaphylactic reactions, the primary treatment should be epinephrine, and antihistamines like Avil (pheniramine maleate) should be used as adjunctive therapy, with a dose of 20-25 mg intravenously or intramuscularly in adults, and 0.5-1 mg/kg/dose in children, always administered after epinephrine and with close monitoring of vital signs 1.
Key Considerations
- Epinephrine is the first-line treatment for anaphylaxis, and its administration should not be delayed, as it is crucial for preventing fatal outcomes 2, 3, 4, 1.
- Antihistamines like Avil are used to manage symptoms such as urticaria and pruritus but do not address life-threatening aspects of anaphylaxis like hypotension and airway compromise.
- The dose of Avil for anaphylaxis can be repeated every 4-6 hours as needed, with a maximum daily dose of 150 mg for adults.
- Corticosteroids are also used in the management of anaphylaxis, but their role should be revisited based on recent findings 1.
Administration and Monitoring
- Avil should be administered after epinephrine, as part of the comprehensive management of anaphylaxis.
- Patients should be closely monitored for vital signs and potential need for additional interventions.
- The use of epinephrine auto-injectors with appropriate needle lengths based on patient weight and body mass index (BMI) is crucial for effective administration 4, 5.