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Author Topic: Benadryl for allergic reaction???  (Read 41132 times)

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Rae

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Benadryl for allergic reaction???
« on: January 21, 2013, 06:26:23 AM »
Hi everyone,

I'm new here and am basically trying to find out if anyone else's doctor is advising against the administration of Benadryl during an allergic reaction. 

My DS (5) is allergic to watermelon, apples and more recently, walnuts.  His recent allergic reaction to walnuts was on Christmas Eve and caught us off guard because he never had a problem before.  We were not aware of the symptoms that were happening before us.  His face finally started to break out in hives and I realized what was going on.  Against my doctors orders, I gave him Benadryl and watched him closely.  My doctor is against giving a child Benadryl so I knew I would get some slack for it but I did not expect him to say if I do it again, he cannot be my doctor, which is what he told my husband and I.  He advises that there is research showing that Benadryl is causing late phase response in patients and then these late phase responses can come on stronger and at times, unexpectedly, when no one is around to administer an EPI, resulting in death.  He advises us that he just had two child deaths as the result of Benadryl.  Then he advised that a doctor is currently on trial for administering Benadryl to a child and is going to jail.  I have googled and googled and googled it trying to find any information to confirm this but haven't been to successful.  He gave me an article on it, but it is one that HE wrote.  Not that I am questioning him, I would just like to know more.  Has anyone else heard of this recently??

Thanks,
Rae

Offline SilverLining

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Re: Benadryl for allergic reaction???
« Reply #1 on: January 21, 2013, 07:00:51 AM »
I have never heard of an allergist being opposed to benedryl for hives, but some do oppose if for anaphylaxis, even in conjunction with epinephrine.   It is common (?) for a bi-phasic reaction to be worse then the original reaction, and it can hit fast.  If you google using that term you will find information.  Hopefully others with more knowledge in this area will also post here.

I am including a link to the American Academy of Pediatris Anaphylaxis Grading Chart .


~~~

Sorry to hear your son went through this at Christmas.
Too many people miss the silver lining because they're expecting gold.  ~~~  Maurice Setter


Offline momma2boys

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Re: Benadryl for allergic reaction???
« Reply #2 on: January 21, 2013, 07:28:00 AM »
Hello and welcome.  Sorry about your childs reaction.  I have not heard anything about that.  For minor reactions we use Benadryl, under dr. orders.  For anaphylaxis, epi.  But even once we got to the ER they gave him more Benadryl.  Whether he is right or wrong, I don't know that I would stay with a dr with that attitude.
peanut, treenut, sesame
Northeast, US

Offline GoingNuts

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Re: Benadryl for allergic reaction???
« Reply #3 on: January 21, 2013, 08:22:38 AM »
I've never heard this either; I do know that Benadryl alone won't stop an anaphylactic reaction so it's always better to epi if there's any question as to severity of reaction.  But I've always heard that administration of Benadryl after epi is pretty standard.

And welcome!  Sorry you had to find us this way.
"Speak out against the madness" - David Crosby
N.E. US

Offline hezzier

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Re: Benadryl for allergic reaction???
« Reply #4 on: January 21, 2013, 08:32:54 AM »
Our allergist (if fact the last 2 allergists) have advised to use benedryl if the reaction is only hives.  Anything beyond/or in place of a hive (my DS usually doesn't get hives) is an epi.


Just curious, is the doctor a pediatrician or an allergist?  Is it possible he's trying to "scare" you into the seriousness of the situation?
DS (12 yrs) TN
DD (15 yrs) cat, wasps and yellow jackets

NH, USA

Offline lakeswimr

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Re: Benadryl for allergic reaction???
« Reply #5 on: January 21, 2013, 08:34:21 AM »
My son's allergist is opposed to giving Benadryl for a food allergic reaction because he says it can mask a reaction getting worse than it has no life saving capabilities.  So, it might hide some of the early signs that a reaction is spreading and is now systemic.  Then, suddenly the reaction pops out over the Benadryl and people can be caught unprepared.  Our emergency plan is to watch for the signs of anaphylaxis and if they occur, epi, benadryl, 911 and ER via ambulance.  I have talked about this elsewhere with a lot of other FA people and it seems about half of allergists agree with my son's allergist and the other half advise Benadryl for minor reactions.  However, support for my allergist's way of thinking seems to be growing and a growing number of allergists are even removing Benadryl from emergency plans altogether.  There have certainly been food allergy fatalities in cases where people gave Benadryl for what they thought was a minor reaction and did not give the epi pen.  Benadryl has been shown to have no life saving capabilities.  It does not thread the part of a reaction that has the potential to become life threatening.  It so for comfort only.  I think giving it can make a person feel they are "doing something" but in reality it isn't going to stop a reaction that is going to progress and become life threatening.  It can make people delay giving the epi pen and do the whole, 'watch and wait' thing.  (BTDT myself.) 

I can believe what your allergist is saying.  I read something yesterday on a different food allergy related topic and I remember thinking last night that apparently all FA related stories do not make it into the news since I hadn't heard of this topic in news stories but it was in this other article at another site. 

Offline LinksEtc

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Re: Benadryl for allergic reaction???
« Reply #6 on: January 21, 2013, 09:55:49 AM »
Here is an older thread about Benadryl vs epi that might be helpful.

Bendaryl vs. Epi ... help!


Offline booandbrimom

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Re: Benadryl for allergic reaction???
« Reply #7 on: January 21, 2013, 10:39:39 AM »
I have looked for information on this for years. This is the only study I've ever seen that tried to evaluate whether H1 blockers cause harm or poorer outcomes:

http://www.ncbi.nlm.nih.gov/pubmed/17253584

As you can see from their review, there's no real evidence either way. Standards are different across different countries. As many physicians swear that H1 blocking can diminish the effects of anaphylaxis (in some cases - and that's an important caveat) as believe it can mask the build-up of anaphylaxis.

I would be skeptical of any doctor who tells me he had two fatalities in his practice from anaphylaxis. I have also not heard of a trial involving food allergies. And, since I've been looking for that research for years, if he has it, I would love to see it.

His take-away is a good one: you should be using an Epi for a walnut reaction. However, IMO his methods are suspect.

What doesn't kill you makes you bitter.

Come commiserate with me: foodallergybitch.blogspot.com

Offline CMdeux

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Re: Benadryl for allergic reaction???
« Reply #8 on: January 21, 2013, 11:15:25 AM »
Yeah, I would think firstly that his absolutism here is pretty suspicious.

The evidence (as Boo and Lakeswimr have both noted) just isn't that clear on the subject.

What is clear is that he isn't giving you much respect as a patient-- and I'd consider his (severe?) dressing down of you over this to be both largely unwarranted* and fairly disrespectful in terms of your patient-doctor relationship.  He's bullying you, not "convincing" you.  There's a difference.

On the other hand, if this is an ALLERGIST, think twice before ditching him because too few allergists understand the relative importance of epinephrine and the relative severity/seriousness of food allergy. 


* assuming that "just hives" is completely accurate as a description of the reaction-- if there were OTHER symptoms, then no, his analysis may have been justified.  See that anaphylaxis grading chart.
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

twinturbo

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Re: Benadryl for allergic reaction???
« Reply #9 on: January 21, 2013, 11:17:22 AM »
Modified after I actually read posts, lol.

Would the following statement be a fair and accurate interpretation of this doctor's orders:

Late or delayed administration of epinephrine, or lack of administration contributes to likelihood of mortality.

instead of

Administration of Benadryl directly increases mortality.
« Last Edit: January 21, 2013, 12:01:56 PM by twinturbo »

Offline lakeswimr

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Re: Benadryl for allergic reaction???
« Reply #10 on: January 21, 2013, 02:24:56 PM »
Yes, I have not heard Benadryl can increase chances of causing a biphasic reaction by itself.  It can increase the chance a person delays epi administration and the chance a person doesn't give the epi at all, thereby increasing the chance of a fatality. 

I also wonder, if your child just got minor hives from eating nuts or if the reaction was more extensive.  Do you have a written emergency plan?  Did you follow it? 

My son's allergist knowns I failed to give the epi when I should have and he never threatened me.  I think that's extreme.  He did tell me to imagine how I would never forgive myself if the worst happened and I hadn't given it, though, and I think that was entirely appropriate for him to say to me. 

Rae

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Re: Benadryl for allergic reaction???
« Reply #11 on: January 21, 2013, 05:36:41 PM »
Thank you everyone for your responses.  My son does see an Allergist.  He actually comes highly recommended.  Just to clarify, he was foreseeing or assisting (the word isn't coming to me at the moment  :-/) with two cases of children who had died as a result on Benadryl, they were not his patients.

This was my sons first allergic reaction like this.  The watermelon and apples only ever resulted in skin rash and hives.  When he had the walnut, he first started coughing a little and saying he had something stuck in his throat.  So I got him something to drink.  He was gagging (but if you know my son, when he doesn't like something he will gag himself and throw up).  I then took him into the bathroom and he threw up.  We came out, he said he was feeling better but then he was pacing and holding his chest saying his chest hurt.  He came and sat on me and I pounded his back a little (still thinking he just had something caught).  He then looked up at me and that's when we saw the hives.   That's when I gave him a Benadryl and then started thinking to myself that I probably should be giving him his EPI.  I kept my eye on him, even slept with him all night cause I was worried, thankfully he was ok.   The next day, I googled it and that's when I read the symptoms and knew he should have had his EPI.   After reading what everyone has to say here, I do believe he is trying to use a scare tactic to get parents to EPI first, which is for our child's safety, so I can appreciate that.  He is concerned about Benadryl masking the reaction.   

I printed out the grading system to keep handy.  Thank you!   

Offline hezzier

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Re: Benadryl for allergic reaction???
« Reply #12 on: January 21, 2013, 06:38:36 PM »
Yes, that would definitely be an epi situation in our house also.  It being his first reaction like that, it's hard to know until after the fact that you should have used the epi.  The important thing is that your son is fine and that if it happens again, then you know it's an epi.
DS (12 yrs) TN
DD (15 yrs) cat, wasps and yellow jackets

NH, USA

Offline CMdeux

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Re: Benadryl for allergic reaction???
« Reply #13 on: January 21, 2013, 07:49:22 PM »
Yup-- what she said!

That grading chart is really helpful-- especially since some of the most serious presentations are not always overt/obviously 'allergic' and not just something else going on. 

We're really glad that you found us, Rae. 
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

Offline lakeswimr

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Re: Benadryl for allergic reaction???
« Reply #14 on: January 21, 2013, 08:38:12 PM »
Did the allergist give you a written emergency plan?  He or she should have and if not I'd request one asap so you don't have to guess when to epi.  The symptoms you described are listed on our plan as time to epi. 

I think the FAAN emergency plan is a good example if you don't yet have a written plan.  Our plan is a bit different than the FAAN one but I don't have it scanned so can't show it to you.  Here is a link to the FAAN plan. 

http://www.foodallergy.org/files/FAAP.pdf

I like it much better than the grading chart.