Anaphylaxis — Premedication for Sensitized Patients — Clinical Pathway: Inpatient

Anaphylaxis Clinical Pathway — Inpatient

Premedication for Sensitized Patients

In patients with known sensitivity to radiographic contrast media, blood products, or immunotherapies, premedication should be considered. Premedication may lessen the clinical manifestations but not prevent reactions in high-risk patients.

Premedication Regimen Begun the Day Prior to Procedure Medication

MedicationRouteDoseMaximum DoseFrequency
Corticosteroid
  • Methylprednisolone
  • Prednisone/Prednisolone
IV
PO		1 mg/kg/dose
1 mg/kg/dose		30 mg/dose
30 mg/dose		Q 6 hrs for 3 doses prior to procedure, then 1 dose prior to start to procedure
H1 Blocker
  • Diphenhydramine
  • Cetirizine (may be less sedating)
IV/PO
PO		1 mg/kg/dose
6-23 months:
2.5 mg/day

2-5 years:
2.5-5 mg/day

> 6 years:
5-10 mg/day		50 mg/dose
10 mg		Q 6 hrs until procedure is completed
Once

Premedication Regimen Begun on Day of Procedure

MedicationRouteDoseMaximum DoseFrequency
Corticosteroid
  • Methylprednisolone
IV
IV		2 mg/kg/dose
1 mg/kg/dose		60 mg/dose
30 mg/dose		Immediately prior to procedure Q 6 hrs until procedure is completed
H1 Blocker
  • Diphenhydramine
  •  
IV/IM1 mg/kg/dose50 mg/dose1 hr prior to procedure