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# For Allergy or Itching: Antihistamines
Itching, sneezing, and rashes caused by allergy can usually be
treated with antihistamines. Any antihistamine works about as well
as any other. So if you do not have chlorpheniramine or
diphenhydramine, use another antihistamine in the right dose (this
will vary for each drug). All antihistamines make people drowsy, but
some more than others.
These drugs are not helpful for the common cold.
Antihistamines should be avoided during pregnancy. If they must be
given, choose a "first generation" antihistamine such as
chlorpheniramine or diphenhydramine, and give with plenty of water.
For a severe allergic reaction where there is difficulty breathing,
epinephrine (adrenaline) is needed as well as antihistamines.
# Chlorpheniramine, chlorphenamine
Chlorpheniramine is an antihistamine that reduces itching, sneezing,
rashes, and other problems caused by allergies. It can be used after
an insect bite, a mild allergy to a food or medicine, or for "hay
fever" (sneezing and itchy eyes from pollen in the air).
## Side effects
Sleepiness (but this is less likely than with other antihistamines).
## Important!
Do not give to pregnant women unless necessary. Do not give during
an asthma attack.
## How to use
Pill
* 1 to 2 years: give 1 mg, 2 times a day until the child feels
better.
* 3 to 5 years: give 1 mg, every 4 to 6 hours until the child feels
better.
* 6 to 12 years: give 2 mg, every 4 to 6 hours until the person
feels better.
* Over 12 years: give 4 mg, every 4 to 6 hours until the person
feels better.
## For severe allergic reaction
First inject epinephrine. Follow with chlorpheniramine by mouth in
the doses listed to help prevent the reaction from coming back when
the epinephrine wears off.
# Diphenhydramine
Diphenhydramine is an antihistamine that reduces itching, sneezing,
rashes, and other problems caused by allergies. It can be used after
an insect bite, a mild food or drug allergy, or for "hay fever"
(sneezing and itchy eyes from pollen in the air).
## Side effects
Sleepiness.
## Important!
* Diphenhydramine may cause dizziness, sleepiness or blurred
vision. Do not drive or operate machinery if using this medicine.
Drinking alcohol may increase the sleepiness caused by
diphenhydramine.
* Do not give to newborn babies or women who are breastfeeding. It
is best not to give diphenhydramine to pregnant women unless
necessary.
* Do not give during an asthma attack.
## How to use
Pill, Injection
The dose is the same for giving diphenhydramine by mouth or as an
injection into the muscle.
* 2 to 5 years: give 6 mg every 4 to 6 hours. Do not give more than
37 mg per day.
* 6 to 11 years: give 12 to 25 mg every 4 to 6 hours. Do not give
more than 150 mg per day.
* Over 12 years: give 25 to 50 mg every 4 to 6 hours. Do not give
more than 400 mg per day.
## For severe allergic reaction
First inject epinephrine. Following with diphenhydramine in the
doses listed will help prevent the reaction from coming back when the
epinephrine wears off.
* 2 to 11 years: give 1 to 2 mg per kg, every 6 hours. If you
cannot weigh the child, use the doses by age listed above, and give
the larger amount. Do not give more than 50 mg at one time, or 300
mg per day.
* Over 12 years: give 25 to 50 mg, every 2 to 4 hours. Do not give
more than 100 mg in 4 hours or 400 mg per day.
# Epinephrine (adrenaline)
Epinephrine is used for severe allergic reaction (anaphylaxis) to
medicines, foods, insect stings or bites, or other things that cause
a severe allergic reaction. It helps reverse the effects such as
difficulty breathing, wheezing, severe skin itching, and hives.
## Side effects
Fear, restlessness, nervousness, tension, headaches, dizziness,
increased heart rate.
## Important!
Epinephrine often comes in ampules of 1 mg per 1 ml liquid.
Epinephrine is also available in preloaded autoinjectors, but these
come in different amounts. Be sure to read to see how much
epinephrine is in your autoinjector to make sure you are giving the
correct amount.
## How to use
Injection
For severe allergic reaction:
Inject into the muscle in the outer part of the mid-thigh.
* 1 to 5 years: inject 1/4 mg (0.25 mg).
* 6 to 12 years: inject 1/3 mg (0.33 mg).
* Over 12 years: inject 1/2 mg (0.5 mg).
If needed, you can give a second dose in 5 to 15 minutes, and a third
dose in 5 to 15 minutes after that. Do not give more than 3 doses.
After giving epinephrine, give an antihistamine such as
chlorpheniramine or diphenhydramine. This will help prevent the
reaction from coming back when the epinephrine wears off.
# Salbutamol (albuterol)
Salbutamol relaxes the muscles in the airway to increase air flow to
the lungs. It is used to treat wheezing or shortness of breath from
asthma or inhaling a lot of smoke from a fire.
## Side effects
Trembling, nervousness, dizziness, fast heartbeat, and headaches.
## How to use
Give 2 puffs from an inhaler (200 micrograms) every 4 to 6 hours as
needed. Use with a spacer for better effects.
It is OK to give more than the amounts listed above if the person
feels they need it.
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