When to use Benadryl, when to use Epi?

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I'm confused as to when to use Benadryl and when to use the Epi-pen? What reaction warrants what? Would I give Benadryl after the Epi or instead of the Epi.? What does Benadryl do and what does Epi-pen do exactly? Thanks in advance.

On Jun 2, 2000

I have never had use an Epi-pen but I have had to use Benadryl. I would only use the benadryl in a minor reaction, such as small hives, puffy eyes, itching. If the symptoms are life threatening, such as difficulty breathing, blue lips, severe swelling, severe hives, I would use the epi-pen while calling 911. Again, I have never used his epi-pen before.

On Jun 2, 2000

My doctor also says to give the antihistamine after the epi. We use zyrtec. We do use zyrtec for minor hives,itchiness or mild rash. We have never used the epi ( knock on wood)!!

On Jun 2, 2000

Anyone ever had their board certified allergist ask why you are even thinking about using Benadryl for a peanut reaction? Where is it said to wait and see how bad the reaction is before you give the Epi? Is it old information?

------------------ Stay Safe,

[email]"Chris@PeanutAllergy.Com"[/email]

On Jun 3, 2000

The initial information I was given was to only use the Epi if she was having trouble breathing. I changed allergists when several people, including 2 EMTs who have dealt with this before and another experienced airborne PA mom said that this would probably be too late! My daughter has had 3 exposures: #s 1 and 2 caused swollen shut eyes and hives. Benedryl was given as instructed by the first allergist and she responded. The 3rd caused her vomit and about 12 hours later, a second reaction set in that cause her eyes, nose and mouth to swell up. Again, she was given Benedryl (but I held the pen in hand and had the 9-1 already dialed on the phone!) I was told by the EMT, after the fact, that she should have probably had the Epi. His logic: "You can reverse the effect of the Epi if the child does not need it and it cannot hurt her. You can't reverse death." We followed up with the new (2nd) allergist and he told us this allergy is usually treated based on prior reactions. However, there is no guarentee that this reaction is not going to be the worst it could be. Were were told that most cases of fatal anaphylaxis were when patients waited until respiratory signs appeared. His answer: over medicate. If my dtr. is exposed again, I won't chance it with Benedryl alone. I will do the Epi and follow up with 911 and Benedryl.

On Jun 3, 2000

Thanks so much for your advice. I'm wondering if anyone out there has used the epi-pen before and what reactions that causes?

On Jun 4, 2000

I've never used the Epi-pen but I understand it can cause an upset stomach, as far as side effects. As far as reactions are concerned, the answers I got, also from an EMT, was that the Epi-Pen was perfectly safe. He could not stress that enough. I was told that even if my daughter was given it and she did not need it or if it she was accidently overdosed (i.e. if we gave her one, it did not help the reaction and had to give her another one and that total was too much for her), that it could be reversed. I double checked this with my daugher's allergist and he confirmed it. The EMT was a great source of information and I highly recommend you speak with your local one if you still have questions. Although they cannot replace your allergist, it's a good source for reliable, quick answers to questions. (Also a good idea because some ambulances are not allowed to carry the Epi-Pen. They also said it was good then new of a PA child in the area.) The EMT I spoke with volunteered information that I would not have otherwise thought of. He offered to go to my daughter's school to educate her classmates and offered to come to our house to make sure we know how to properly administer the Epi-pen. Some of the information he gave me helped me to ask the allergist more educated questions.

On Jun 4, 2000

I've used the epipen! Unfortunately!

When my daughter was 15 months old, we tried goats milk, on a very stupid pediatricians recommendation. We already knew that she was allergic to milk. At the time I did not know that the protein in cow's milk and goat's milk is the same, and obviously the Dr. didn't either.

Anyways, with less than a teaspoon of milk, she reacted quickly, first swelling, then choking. I waited no longer and gave the epipen Jr. while my sister drove us both to the hospital. Immediately after the epi she vomitted and then breathing was fine. She was very high on the drug that was the worse part, the best was seeing how fast the epi pen works. If you are at all queasy I wouldn't recommend looking at the needle after the injection.

We were lucky, I had asked for the epi pen about two months earlier, they didn't feel I needed one!

Hoping we'll never have to use it again, but always have it with her.

On Jun 4, 2000

We had to use the epi once, but it wasn't for peanuts, it was for cats. The only thing I really remember was his heart pounding and his pulse racing.

Our allergist told us to do benedryl first, if not satisified, administer epi and call 911...however this was based on HIS history.

On Jun 5, 2000

Wow! I always wondered if environmental, pet allergies could become anaphylactic. Thanks for the info!

On Jun 5, 2000

My doctor told me to immediately administer the epipen to my child the if he ingests any peanut products. She said not to wait for a reaction because it might be too late. Thank goodness I have not had to do this.

On Jun 5, 2000

Well.....unfortunately I have had my share of epi shots. and....I don't know which is worse, the reaction to the peanuts, the reaction to the epi, or thepanic that goes with both! it is best to inject it into the thigh or hip, (that is what they told me and did to me in the ER) and ALWAYS call 911 or go to the hospital afterwards....I haven't always done this, but it is better to be safe than sorry (especially with the kids who can not necessarily describe how they are feeling). Sometimes the ER follows up with steroid shots and also monitors hydration. My brother also had a reaction to the smell of peanut brittle (he was working in a bakery!) and he was in the hospital for two days. I read on here that someones doctor said you can not have anaphalaxis due to smell.,.....well he's wrong. Sorry....but these researchers need to do their homework on those that it has happened to! I use the epi if EVER in doubt...if I begin to feel my throat close or hives on the inside of the mouth....definitely. Another question that the ER will ask is if the tongue goes numb...to use it. I say don't wait! question??? which is better, liquid benadryl or capsule??? which works quicker for everyone?

On Jun 5, 2000

I have a hard time with the issue of what kind of Benadryl to give or if I should even give it first. My son's last two reactions have included inability to swallow with excessive saliva pouring from his mouth so I don't know if he would be able to swallow the Benadryl!

On Jun 5, 2000

Our allergist's advice is to inject the epi-pen if there is ANY known ingestion of peanuts or nuts, call 911, then give Benadryl. If there is no known ingestion, and there are only a couple hives and no other symptoms, I can give Benadryl (we were told that the liquid is absorbed more quickly into the system) and observe if any symptoms develop further.

I was also told that if there is more than one area or system of the body involved - such as hives (skin) plus vomiting (Gastro-intestinal)or wheezing (respiratory), OR hives that are not just localized (for example, a couple near the mouth AND some on the belly), then there is a strong indication of a SYSTEMIC reaction. In that case, give the epi, even if the individual symptoms are not that severe (only a couple hives, along with moderate GI upset, etc.) -

NaomiR, if I saw difficulty swallowing and excessive saliva in my child I would give my child the epi - as I'd be concerned that those are indicators of swelling in the mucous membranes of the mouth and throat. I was also told that if there is swelling of any area of the mouth, it is likely that the swelling continues down the throat.

Since my son is only two years old, I can't really count on what he can tell me he is experiencing - so, until I can, I'd have to follow these guidelines. Also, his initial reaction was to contact (probably a kiss)and he's never actually ingested peanuts, so I wouldn't know what a "typical" reaction would be for him - and I'd rather err on the side of caution. He's been diagnosed for more than a year now, and, thank god, no need to use the epi-pen yet.

I hope I'd have the courage and presence of mind to do the right thing in an emergency.

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[This message has been edited by Yonit (edited June 05, 2000).]

On Jun 5, 2000

Why so many threads on the same topic, one in April as well...Anyway, Ditto to what most have said so far above...that is, epi is more important than the benadryl.

Any signs of a reaction warrant an epi, but (IMHO)not any benadryl. I was told by a leading allergist that using benadryl may in fact mask symptoms (that you need to see). So if a few hives show up, you dont want them to just go away for a few minutes or hours because of the administration of benadryl. You want to know of any symptoms which can be a sign of a more severe reaction that my be oncoming. You dont want your child sleepy either.

I would be giving epi or nothing, but not benadryl. A few hives masked by benadryl can lead to a full blown reaction hours later. Benadryl does not do the same as an epi... i dont remember reading that benadryl is a jr. version of an epipen!

On Jun 6, 2000

Thank you everyone for your responses. I feel very clear now that I will give the epi-pen and call 911 in a known ingestion and take my daughter to the ER if I 'think' she's been exposed so she can be monitored in a safer environment. Let's not take risks. We don't want to be left with any "if only I'd done it sooner" scenarios. Good luck everyone and be safe.

On Jun 15, 2000

I have been reading through these responses because I am also curious as to when to use the epi-pen, but if I were to give my son an injection every time he has a symptom, that would be every day! He is allergic to eggs, milk, wheat, and peanuts. If my husband drinks milk or even handles a carton of ice cream, my son gets hives wherever he was touched. He gets a red swollen eye and runny nose with wheat. Many times his eyes are swollen, especially when he wakes up. So far he hasn't seemed to have trouble breathing but he is only 8 months and it's hard to tell all his reactions because he obviously can't tell me. Anyway, I'm still confused as to when to use the epi-pen. Of course I don't want a bad reaction to get out of hand, but I don't want to inject every time there is a little flare-up. Any ideas for me?

On Jun 16, 2000

I would urge anyone unclear as to what to do to CONTACT YOUR ALLERGIST! What I was told may not be what is right for your child. My friend and I go to the same allergist but our children have had different experiences to Peanut, egg and we were told differnet things. We asked why and the doc said treatment is based on the individual. Also, I've said this before, most pediatricians are not well versed in allergic reactions esp food. For months my (EX) ped told me my son was to young to have hives and an allergic reaction, that his "hives" must have been bug bites. Needless to say after I fired him I sent him our RAST results...

On Jun 19, 2000

nlsess: When our son was your childs age, he was also diagnosed with the exact same allergies: peanut, egg, wheat and milk (dairy). He would have similar reactions; hives or swollen eyes....Benedryl always worked just fine. Our son has the potential to be anaphalactic to peanuts (maybe eggs-- don't really know). So what I understand is that the epi-pen is for anaphalactic reactions, not the minor reactions that our son would have to wheat and milk. He has had many many cases of hives, swollen eyes, even vomiting......from alergic reactions but only one time did we give the epi and that was this summer when we suspect he ate something with a peanut in it. It was obvious that it was not a "normal" reaction; his lips were swelling up, he vomited and soon became covered head to toe with hives. So, talk with your allergist again so you will know for sure. Your child may not be anaphalactic to everything he is allergic to. By the way, our son just turned 5. He "outgrew" his wheat allergy several years ago and is now tolerating more and more foods with dairy in them. We believe he is still allergic to eggs (actually I am not sure but I won't test it out!) and, of course, we know he is still allergic to peanuts. So, just have hope that your child may "outgrow" some of these allergies. It is wonderful when they do! Only another parent of an allergic child can understand the joy when your child can finally eat bread, noodles or cheese.... Tracy

On Jun 19, 2000

The epi-pen is epinephrine and prevents the histamine reaction and increase the contractions of the heart and output. It will also relax the broncial smooth muscles. Yes this is not off the top of my head I looked it up. So it makes the allergy attack stop and increased the heart rate. It is always the first line drug to give. Benadryl is the broadest spectrum antihistamine. So it can be taken for allergies, motion sickness colds and much more. Benadryl is given after the epi-pen I think because the epi has more affects on the output of the heart. I need to clarify that the epi-pen is given for an anaphylactic shock. I use the benedryl for just hives and one reaction. My allergist instructed me to use the epi-pen after my son eats peanuts or walnuts even knowing his only reation was hives. You need to ask your doctor to clarify when to use the epi-pen.

[This message has been edited by jrizos (edited June 19, 2000).]

On Jun 24, 2000

My son is 5 and suffers from multiple allergies.I would like to question when to give the epipen.E.was injected 3 times this week.Yesterday the specialist said that I should have given him antihistimine for the facial and tongue swelling.It says on his care plan to inject for facial swelling.He was treated initially in the local ER.The nurse injected the same epipen twice so I dont believe he got all his dose.His temperature was high ,he was droolling and very drowsy after his injection.Usually after epipen he makes a quick recovery and is hyper.The Specialist said that adrenaline can cause high temp and raised BP.He usually develops a high temperature & drowsiness when he is reacting.After an eventful week a tooth abcess appeared and the Specialist said that infections can trigger allergic reactions in allergic people but these reactions are rarely lifethreatening.Has anyone ever heard of a condition called Angioedema-swelling for no reason?This is what is being queried with my son now.

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On Jun 24, 2000

Hi kpohagen, Sorry you and your son had such a rough weak. I am a nurse. I looked up this in several books and finally found it in the last one. This is a symptom of anaphlactic shock and is caused from a fluid shift in the body. Fluid leaves the cells and goes to the blood stream. The fluid shift may be significant enough to result in decreased blood pressure and shock. This can be stopped with the epinephren. You will see it affect the mucuous membranes. The drooling and the low blood pressure sounds like symptoms of angioedema. I hope this info helps and your son gets better. I thought I was having a hard week. One of my kids ran into a cement wall and misplaced his top teeth. OOh the pain and his teeth. Thank god they are baby teeth. I am going away for five weeks to Greece I will miss this sight and conversing with everyone.

On Jun 24, 2000

Hi jrizos, I much appreciate your answer.Hope your little one feels better.Don't they always decide to harm themselves when you least expect.Have a great time in Greece.Many thanks again.

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