Don’t rely on antihistamines as firstline treatment in severe allergic reactions.
|Rationale and Comments:||Epinephrine is the first-line treatment for anaphylaxis. Data indicate that antihistamines are overused as the first-line treatment of anaphylaxis. By definition, anaphylaxis has cardiovascular and respiratory manifestations, which require treatment with epinephrine. Overuse of antihistamines, which do not treat cardiovascular or respiratory manifestations of anaphylaxis, can delay the effective first-line treatment with epinephrine. Epinephrine should be administered as soon as the diagnosis of anaphylaxis is suspected. Antihistamines are second-line supportive therapy for cutaneous non–life-threatening symptoms (hives), but do not replace epinephrine as the first-line treatment for anaphylaxis. Fatalities during anaphylaxis have been associated with delayed administration of epinephrine.|
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