The following medical news items are relevant to treatment of Adverse reaction:
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At the first sign of a hemolytic reaction, stop the transfusion immediately. Depending on the nature of the patient’s reaction, prepare to:
❑ monitor vital signs every 15 to 30 minutes, watching for signs of shock
❑ maintain a patent I.V. line with normal saline solution; insert an indwelling catheter and monitor intake and output
❑ cover the patient with blankets to ease chills, and explain what’s happening
❑ deliver supplemental oxygen at low flow rates through a nasal cannula or bag-valve-mask (handheld resuscitation bag)
❑ give drugs as ordered: an I.V. antihypotensive drug and normal saline solution to combat shock, epinephrine to treat dyspnea and wheezing, diphenhydramine to combat cellular histamine released from mast cells, corticosteroids to reduce inflammation, and mannitol or furosemide to maintain urinary function. Administer parenteral antihistamines and corticosteroids for allergic reactions. (Severe reactions such as anaphylaxis may require epinephrine.) Administer antipyretics for nonhemolytic febrile reactions and appropriate I.V. antibiotics for bacterial contamination.
Source: Professional Guide to Diseases (Eighth Edition), 2005
For many patients, treatment involves a sunscreen, protective clothing, and minimal exposure to sunlight while the patient continues on the drug. For others, progressive exposure to sunlight can thicken the skin and produce a tan that interferes with photoallergens and prevents further eruptions.
Withdrawal of the causative agent and treatment with oral steroids usually provides relief. The patient should be advised not to use the causative agent again if it’s known, even though this may limit the patient’s treatment options.
Antimalarial drugs, beta-carotene, and PUVA (psoralen and UVA) may be used to treat PMLE. Treatment for solar urticaria may also require PUVA. Although hyperpigmentation usually fades in several months, hydroquinone preparations can hasten the process.
Source: Professional Guide to Diseases (Eighth Edition), 2005
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