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. 2011 Jan;16(1):35–40.

TABLE 3.

Pharmacological management of anaphylaxis

Drug and route of administration Frequency of administration Paediatric dosing (maximum dose)
Epinephrine (1:1000) IM Immediately, then every 5–15 min as required 0.01 mg/kg (0.5 mg)
Cetirizine PO Single daily dose 6 months to <2 years: 2.5 mg OD
 2–5 years: 2.5–5 mg OD
 >5 years: 5–10 mg OD
Diphenhydramine IM/IV Every 4–6 h as required for cutaneous manifestations 1 mg/kg/dose (50 mg)
Ranitidine PO/IV Every 8 h as required for cutaneous manifestations 1 mg/kg/dose (50 mg)
Corticosteroids: prednisone PO or methylprednisolone IV Every 6 h as required 1 mg/kg PO (75 mg) or 1 mg/kg IV (125 mg)
Salbutamol Every 20 min or continuous for respiratory symptoms (wheezing or shortness of breath) 5–10 puffs using MDI or 2.5–5 mg by nebulization
Nebulized epinephrine (1:1000) Every 20 min to 1 h for symptoms of upper airway obstruction (stridor) 2.5–5 mL by nebulization
Epinephrine IV (infusion) Continuous infusion for hypotension – titrate to effect 0.1–1 μg/kg/min (maximum 10 μg/min)
Glucagon IV Bolus followed by continuous infusion – titrate to effect 20–30 μg/kg bolus (maximum 1 mg), then infusion at 5–15 μg/min

IM Intramuscular; IV Intravenous; MDI Metered dose inhaler; OD Once daily; PO Oral