70 Where There Is No Doctor 2011
DANGEROUS REACTIONS FROM INJECTING
CERTAIN MEDICINES
The following groups of medicines sometimes produce a dangerous reaction called
ALLERGIC SHOCK a short time after injection:
• penicillins (including ampicillin)
• antitoxins that are made from horse serum
{scorpion antivenom
snake antivenom
tetanus antitoxin
The risk of a serious reaction is greater in a person who has previously been injected
with one of these medicines or with another medicine of the same group. This risk
is especially great if the medicine caused an allergic reaction (hives, rash, itching,
swelling, or trouble breathing) a few hours or days after the injection was given.
Rarely, ALLERGIC SHOCK may
result from the sting of a wasp or bee or
from medicine taken by mouth.
To prevent a serious reaction from an injection:
1. Use injections only when absolutely necessary.
2. Before injecting one of the medicines listed above, always have ready 2 ampules
of epinephrine (Adrenalin, p. 385) and an ampule of an antihistamine like promethazine
(Phenergan, p. 385) or diphenhydramine (Benadryl, p. 386).
3. Before injecting, always ask if at any other time a similar injection caused itching or
other reactions. If the person says yes, do not use this medicine or any other medicine of
the same group, either injected or taken by mouth.
4. In very serious cases, like tetanus or snakebite, if there is a good chance that
the antitoxin might produce an allergic reaction (if the person suffers from allergies
or asthma or has had horse serum before), inject promethazine or diphenhydramine
15 minutes before giving the antitoxin: adults, 25 to 50 mg.; children, 10 to 25 mg.,
depending on their size (see p. 386).
5. After injecting any medicine, always stay with the person for 30 minutes to watch
for any of the following signs of ALLERGIC SHOCK:
• cool, moist, pale, gray skin (cold sweat)
• weak, rapid pulse or heartbeat
• difficulty breathing
• loss of consciousness
6. If these signs appear, immediately inject epinephrine (Adrenalin): adults, 1/2 ml.;
children, 1/3 to 1/4 ml, depending on their size. Treat the person for SHOCK (see p. 77).
Follow by giving an antihistamine in double the normal dose.