Allergic Reactions

Generalized allergic reactions can vary greatly in severity, from mild itching to life-threatening anaphylaxis, and may occur in response to:

  • foods (especially strawberries, nuts, chocolate, shellfish)
  • medications
  • substances called contrast materials that are injected into the body during certain X-ray procedures
  • insect stings

Allergic Reactions Symptoms of Mild Reactions

  • rash – typically scattered widely over the body. Raised, itchy welts called hives are a common manifestation of a generalized allergic reaction.
  • generalized itching

Allergic Reactions Symptoms of Moderate Reactions

  • All of the above, and
  • swelling of the face, tongue, or throat
  • wheezing/coughing
  • light-headedness

Allergic Reactions Symptom of Anaphylaxis (Anaphylactic Shock)

In the more severe, life-threatening reaction known as anaphylaxis, these symptoms may develop very rapidly and be very intense. In addition to the above, the following may occur:

  • difficulty swallowing or breathing
  • nausea/vomiting
  • abdominal cramps
  • sudden drop in blood pressure, manifested by pale, clammy skin; altered consciousness or unconsciousness; and rapid, weak pulse

Anaphylaxis may lead to cardiac arrest and death if not treated promptly.

Treatment for Mild Allergic Reactions

  • Use antihistamines – especially diphenhydramine (Benadryl and others) or clemastine (Tavist) – to help relieve itching, swelling, and hives.
  • Lie down if feeling light-headed.
  • If you think the reaction involves a medication, withhold further doses until you consult your child’s physician.
  • When a drug reaction (of any kind – see below) has occurred, remind your child’s doctor during the next office visit to ensure that the information about the reaction is recorded on the child’s permanent medical record.

Treatment for Moderate Allergic Reactions

  • All of the above. In addition, contact your child’s physician immediately or go to the nearest emergency room.

Treatment for Severe Allergic Reactions

For severe reactions (those involving rapid swelling of face/throat/tongue or difficulty breathing):

  • Call 911.
  • If the child has been bitten, stung, or has ingested a substance, any of which have caused severe reactions in the past, call 911, even before symptoms are evident.
  • Try to keep yourself and your child calm.
  • If the child is wheezing and has an inhaler available that is intended for acute (not maintenance, such as Serevent) treatment of wheezing, have him use it as directed.
  • If the child has an emergency kit (for example, EpiPen or Ana-Kit) containing syringes prefilled with epinephrine (adrenalin), follow the instructions for giving this injection.
  • Check the ABCs – airway, breathing, and circulation. If necessary, begin CPR.
  • If the episode follows a bee sting, remove the stinger. Scrape it off with a credit card or other flat object – do not use tweezers, since this may squeeze more venom into the skin.
  • If the child feels faint, have him lie down on a flat surface, cover him with a blanket or a coat, and elevate his feet 8 to 12 inches (to help maintain his blood pressure).
    DO NOT elevate the head if there is a breathing problem; this may aggravate a blockage of the airway.
  • After your child has had an anaphylactic reaction, talk to his doctor about obtaining emergency treatment kits containing an injection of epinephrine (for example, EpiPen or Ana-Kit) that can partially or completely reverse the reaction. These should be available at home, in the car, and in the gear taken on camping trips or other outings. A child who has had an anaphylactic reaction should wear a medical ID tag with this information, especially if he may need an emergency injection of epinephrine.

A child can have an allergic reaction to a substance that has never caused problems before, even with many prior contacts. If a reaction occurs, every reasonable effort should be made to prevent contact with that substance in the future because reactions that were initially mild can become more severe with further exposure.

Allergic Reaction or Drug Side Effect?

Some children (and adults) experience side effects from over-the-counter (OTC) or prescription medications. Examples of common side effects are drowsiness with many antihistamines, nausea and/or diarrhea from certain antibiotics, and dry mouth from some forms of antidepressants. These reactions can vary considerably from person to person, and overtime they can also change in a given individual using the same drug. Usually the potential side effects of a medication are listed on the label of an OTC drug. For prescription drugs, the physician will often review possible side effects, or the effects will be noted by the pharmacist when the prescription is filled.

Side effects are not the sane as allergic reactions, which involve a specific response of the immune system. Distinguishing between side effects and allergic reactions is important: if a true allergic reaction has occurred, repeated doses of the same or a related drug might cause a more serious reaction in the future. By contrast, side effects may or may not occur if the drug is taken in the future. Sometimes a symptom that might seem like a drug reaction actually has no relationship to the medication, and the timing of its appearance is purely co-incidental. Deciding whether or not a drug has caused a particular problem and whether it may be safely taken in the future can often be difficult and you should talk over it with your child’s physician.