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Prednisone dose for bee sting.Insect Stings and Bites
- Prednisone dose for bee sting
Prednisone dose for bee sting -
Search this site. Search all sites. Background Bees, wasps and ants belong to the insect order Hymenoptera Stings are common in children, particularly during spring and summer Native Australian bees rarely sting; the introduced honeybee and to a lesser extent, the European wasp is responsible for the majority of problematic insect stings Allergic reactions to bull ants, especially Jack Jumper ants Myrmecia genus , are an increasing concern in eastern Australia.
March flies and ticks may cause similar reactions. Airway and circulatory symptoms are unlikely. Gastrointestinal symptoms vomiting, diarrhoea predominate. Renal failure due to release of tissue breakdown products may complicate multiple stings bee or wasp several days after the event Treatment is supportive Delayed serum sickness - this may occur days after the sting, with morbiliform rash, uticaria, myalgia, arthralgia and low grade fever.
Management The majority of children who are stung will not need any medical treatment. First aid for stings Remove sting if present as quickly as possible, by scraping with the edge of a flat object long fingernail, knife blade Analgesia - Simple analgesics and a cold compress applied to the sting site may relieve pain Anaphylaxis - this is a medical emergency.
Refer to Anaphylaxis Local symptoms Symptoms often resolve in a few hours and an oral analgesic and cold compress may be helpful Oral antihistamines may alleviate itch and may prevent progression to systemic reactions in children with a previous history of systemic reactions to insect stings. Large local reactions commonly peak at hours and may persist for several days.
Elevate the affected limb and apply a cold compress. The appearance may resemble cellulitis but antibiotics should be avoided unless swelling increases more than 48 hours after the sting or systemic signs suggest secondary infection.
Minor allergic symptoms - general urticaria, pruritus or angio-oedema An oral antihistamine is recommended doses as above The child should be closely watched over the next hours for signs of anaphylaxis. The majority of children who die from insect stings have no prior history of anaphylaxis. It should be administered if the child develops any signs of anaphylaxis.
Australian Medicines Handbook Pty Ltd. Accessed, up to date. Fleisher, Gary R. Ludwig, Stephen. Textbook of Pediatric Emergency Medicine, 6th Edition. Related guidelines Anaphylaxis. In previous reports, the minimal effective dose of omalizumab to protect from systemic reactions to VIT was mg [ 10 ], thus the search of the protective dose should start from mg, with increase to mg and, possibly, to mg in case of incomplete protection. The most appropriate combination therapy including also corticosteroids and antihistamines is not yet established and needs be investigated.
Venom immunotherapy for preventing allergic reaction to insect stings. Safety of hymenoptera venom immunotherapy: a systematic review. Expert Opin Pharmacother. Analysis of safety, risk factors and pretreatment methods during rush hymenoptera venom immunotherapy. Int Arch Allergy Immunol. Intolerance of specific immunotherapy with Hymenoptera venom: jumping the hurdle with omalizumab.
Severe anaphylaxis to bee venom immunotherapy: efficacy of pre-treatment and concurrent treatment with omalizumab. J Investig Allergol Clin Immunol. Kontou-Fili K. High omalizumab dose controls recurrent reactions to venom immunotherapy in indolent systemic mastocytosis. Article Google Scholar. Failure of omalizumab treatment after recurrent systemic reactions to bee-venom immunotherapy.
Mueller HL. Diagnosis and treatment of insect sensitivity. J Asthma Res. Patients still reacting to a sting challenge while receiving conventional Hymenoptera venom immunotherapy are protected by increased venom doses.
J Allergy Clin Immunol. Treatment with a combination of omalizumab and specific immunotherapy for severe anaphylaxis after a wasp sting. Int J Immunopathol Pharmacol. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Elisa Boni. Reprints and Permissions. Boni, E.
Dose-dependence of protection from systemic reactions to venom immunotherapy by omalizumab. Clin Mol Allergy 14 , 14 Download citation. Received : 17 June Accepted : 16 October Published : 24 October Anyone you share the following link with will be able to read this content:.
Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Case presentation We present the case of a 47 years old woman allergic to bee venom who experienced two severe SRs after bee stings and several SRs to VIT with bee venom. Conclusions The search of the dose of omalizumab able to protect a patient with repeated SRs to VIT may be demanding, but this search is warranted by the need to provide to this kind of patient, by an adequate VIT, the protection from potentially life-threatening reactions.
Background Venom immunotherapy VIT is generally safe and, differently from injective immunotherapy with inhalant allergens, no fatal reaction to treatment has been reported [ 1 ].
Clinical and Molecular Allergy volume 14Article number: 14 Cite this article. Metrics details. In patients with repeated SRs to VIT it is difficult to reach the maintenance dose of venom and pre-treatment with omalizumab is indicated, as shown by some studies reporting its preventative capacity, when antihistamines and corticosteroids are ineffective.
We present the case of a 47 years old woman allergic to bee venom who experienced two severe SRs after bee stings and several SRs to VIT with bee venom. Pre-treatment with antihistamines and corticosteroids as well as omalizumab at doses up to mg was unsuccessful, while an omalizumab dose of mg finally achieved in our patient the protection from SRs to VIT with mcg of bee venom.
The search of the dose of omalizumab able to protect a patient with repeated SRs to VIT may be demanding, but this search is warranted by the need to provide to this kind of patient, by an adequate VIT, the protection from potentially life-threatening reactions. Venom immunotherapy VIT is generally safe and, differently from injective immunotherapy with inhalant allergens, no fatal reaction to treatment has been reported [ 1 ].
Still, systemic reactions SR may occur, with a rate significantly higher for honeybee than for vespid VIT. In fact, a systematic review defined a rate of SRs of In patients with repeated SRs it is difficult to reach the maintenance dose of venom, usually corresponding to mcg [ 1 ].
Mild to moderate SRs may be averted by pre-treatment with antihistamines [ 3 ], while for severe SRs pre-treatment with omalizumab is indicated, as shown by some studies reporting its preventative capacity [ 4 — 6 ]. However, a negative study was published [ 7 ]. We describe the case of a patient with repeated SRs to honeybee VIT who initially was apparently not responsive to the omalizumab treatment but achieved the complete prevention of SRs by dose increase.
The patient is a woman exposed to honeybee stings because her father is a beekeeper. At the age of 22 years she experienced a SR of grade 4 severity according to Mueller [ 8 ] after a single bee sting.
Honeybee venom hypersensitivity was then diagnosed by skin tests and VIT for bee venom was started. No other stings until the age of 47 years when the patient had a further SR again grade 4 according to Mueller after a bee sting. According to clinical history, no additional allergy neither other medical conditions were present. InVIT for bee venom was then scheduled by honeybee venom from Stallergenes Antony, France but already during the build-up phase, at the dose of 10 mcg of venom, a SR with angioedema of the glottis, cough, itching of hands and feet occurred, requiring epinephrine administration for resolution of the symptoms Table 2.
Premedication with terfenadine mg twice a day in the three days before VIT was attempted but anaphylaxis occurred again at the dose of 10 mcg and administration of epinephrine was again necessary. Omalizumab mg was administered twice with a 14 day interval during the build-up phase of VIT with a modified rush schedule at weekly interval Table 3.
However, when reaching the dose of 10 mcg the patient had cough and dysphagia. This suggested to step down omalizumab to mg every 2 weeks and using oral premedication with prednisone 25 mg, rupatadine 10 mg and ranitidine mg. VIT and omalizumab administrations were set on different days. However, when omalizumab was reduced to mg once a month a SR requiring epinephrine occurred. Therefore, the dose of omalizumab was doubled to mg once a month along with the oral premedication with the usual drugs letting the patient tolerating the monthly dose of mcg of bee venom.
Finally, when increasing the dose of omalizumab to mg monthly, 2 days before VIT, preceded by oral premedication with prednisone, rupatadine and ranitidine 12 and 2 h before VIT, the patient no longer suffered from SRs over the last 14 months and is still under regular treatment.
VIT is a highly effective treatment but not all patients are protected from SRs by the usual maintenance dose of mcg. Rueff et al. The case we report shows that also the search of the dose of omalizumab able to protect a patient with repeated SRs to VIT may be demanding, but this pursuit is warranted by the need to provide to this kind of patient, by an adequate VIT, the protection from potentially life-threatening reactions. In previous reports, the minimal effective dose of omalizumab to protect from systemic reactions to VIT was mg [ 10 ], thus the search of the protective dose should start from mg, with increase to mg and, possibly, to mg in case of incomplete protection.
The most appropriate combination therapy including also corticosteroids and antihistamines is not yet established and needs be investigated. Venom immunotherapy for preventing allergic reaction to insect stings. Safety of hymenoptera venom immunotherapy: a systematic review.
Expert Opin Pharmacother. Analysis of safety, risk factors and pretreatment methods during rush hymenoptera venom immunotherapy. Int Arch Allergy Immunol. Intolerance of specific immunotherapy with Hymenoptera venom: jumping the hurdle with omalizumab. Severe anaphylaxis to bee venom immunotherapy: efficacy of pre-treatment and concurrent treatment with omalizumab.
J Investig Allergol Clin Immunol. Kontou-Fili K. High omalizumab dose controls recurrent reactions to venom immunotherapy in indolent systemic mastocytosis. Article Google Scholar.
Failure of omalizumab treatment after recurrent systemic reactions to bee-venom immunotherapy. Mueller HL. Diagnosis and treatment of insect sensitivity.
J Asthma Res. Patients still reacting to a sting challenge while receiving conventional Hymenoptera venom immunotherapy are protected by increased venom doses. J Allergy Clin Immunol. Treatment with a combination of omalizumab and specific immunotherapy for severe anaphylaxis after a wasp sting. Int J Immunopathol Pharmacol. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Elisa Boni. Reprints and Permissions. Boni, E. Dose-dependence of protection from systemic reactions to venom immunotherapy by omalizumab.
Clin Mol Allergy 1414 Download citation. Received : 17 June Accepted : 16 October Published : 24 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Case presentation We present the case of a 47 years old woman allergic to bee venom who experienced two severe SRs after bee stings and several SRs to VIT with bee venom.
Conclusions The search of the dose of omalizumab able to protect a patient with repeated SRs to VIT may be demanding, but this search is warranted by the need to provide to this kind of patient, by an adequate VIT, the protection from potentially life-threatening reactions. Background Venom immunotherapy VIT is generally safe and, differently from injective immunotherapy with inhalant allergens, no fatal reaction to treatment has been reported [ 1 ].
Case presentation The patient is a woman exposed to honeybee stings because her father is a beekeeper. Table 2 Previous attempts of buildup phase with HB venom Full size table. Table 3 Build up phase with administration of omalizumab Full size table. Conclusions VIT is a highly effective treatment but not all patients are protected from SRs by the usual maintenance dose of mcg.
Acknowledgements None. Competing interests E. Consent for publication Signed consent to publish was obtained from the patient.
View author publications. About this article. Cite this article Boni, E. Copy to clipboard. Contact us Submission enquiries: Access here and click Contact Us General enquiries: info biomedcentral.
The stinger of a black honey bee, torn from the bee's body and attached to a topical steroids, and even a single oral dose of mg prednisone have. When visible a bee or wasp sting may be removed carefully. of a short course of steroids like prednisolone pills to be taken for three to five days. Other treatments for the discomfort and swelling of a local reaction to a sting include rubbing meat tenderizer, an aluminum-based deodorant, or. Bees sting only once, leaving the sting and poison sac in the victim, A single dose of oral prednisolone (1 mg/kg)1 may improve symptoms. Low-dose prednisone is used to reduce inflammation or in certain types of hormone replacement therapy. In larger doses and/or longer duration of treatment. Dose-dependence of protection from systemic reactions to venom immunotherapy by omalizumab. The dose of this medicine will be different for different patients. Your dose of this medicine might need to be changed for a short time while you have extra stress. The case we report shows that also the search of the dose of omalizumab able to protect a patient with repeated SRs to VIT may be demanding, but this pursuit is warranted by the need to provide to this kind of patient, by an adequate VIT, the protection from potentially life-threatening reactions. Immunotherapy Immunotherapy may be given at intervals for up to three years.Drug information provided by: IBM Micromedex. Prednisone provides relief for inflamed areas of the body. It is used to treat a number of different conditions, such as inflammation swelling , severe allergies, adrenal problems, arthritis, asthma, blood or bone marrow problems, endocrine problems, eye or vision problems, stomach or bowel problems, lupus, skin conditions, kidney problems, ulcerative colitis, and flare-ups of multiple sclerosis.
Prednisone is a corticosteroid cortisone-like medicine or steroid. It works on the immune system to help relieve swelling, redness, itching, and allergic reactions. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:.
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals.
For non-prescription products, read the label or package ingredients carefully. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of prednisone in children.
However, pediatric patients are more likely to have slower growth and bone problems if prednisone is used for a long time. Recommended doses should not be exceeded, and the patient should be carefully monitored during therapy. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of prednisone in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for elderly patients receiving prednisone.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur.
In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below.
The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur.
Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
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Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Measure the concentrated liquid with the special oral dropper that comes with the package. If you use this medicine for a long time, do not suddenly stop using it without checking first with your doctor. You may need to slowly decrease your dose before stopping it completely.
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If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Keep from freezing. If you will be taking this medicine for a long time, it is very important that your doctor check you at regular visits for any unwanted effects that may be caused by this medicine. Blood or urine tests may be needed to check for unwanted effects. Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.
If you are using this medicine for a long time, tell your doctor about any extra stress or anxiety in your life, including other health concerns and emotional stress. Your dose of this medicine might need to be changed for a short time while you have extra stress.
Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor right away if you have more than one of these symptoms while you are using this medicine: blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness.
This medicine may cause you to get more infections than usual. Avoid people who are sick or have infections and wash your hands often. If you are exposed to chickenpox or measles, tell your doctor right away.
If you start to have a fever, chills, sore throat, or any other sign of an infection, call your doctor right away. Check with your doctor right away if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment.
Your doctor may want you to have your eyes checked by an ophthalmologist eye doctor. While you are being treated with prednisone, do not have any immunizations vaccines without your doctor's approval. Prednisone may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent.
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Tell your doctor if you have any bone pain or if you have an increased risk for osteoporosis. If your child is using this medicine, tell the doctor if you think your child is not growing properly. Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain skin tests. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription over-the-counter [OTC] medicines and herbal or vitamin supplements.
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