Hives swelling anaphylaxis Buff W Powell P Insect Bites and Stings and

Hives, swelling, anaphylaxis Buff W, Powell P. Insect Bites and Stings and Pediculosis. In: Krinsky DL, Handbook of nonprescription drugs . 17 th ed. Washington DC: American Pharmacist’s Association; 2012; 675-691. Fire Ants • Found in southern and western United States • Live in underground colonies • Presentation • Intense itching, burning • Tissue necrosis • Anaphylactic reactions Buff W, Powell P. Insect Bites and Stings and Pediculosis. In: Krinsky DL, Handbook of nonprescription drugs . 17 th ed. Washington DC: American Pharmacist’s Association; 2012; 675-691. Prevention of Insect Stings • Protective covering • Avoid bright colored clothing • Avoid scented lotions, perfumes, cologne • Change contaminated clothing (food, drink spills) • Destroy nests near home Buff W, Powell P. Insect Bites and Stings and Pediculosis. In: Krinsky DL, Handbook of nonprescription drugs . 17 th ed. Washington DC: American Pharmacist’s Association; 2012; 675-691. Approach to Treatment of Insect Stings • Goals of self-treatment • Relieve itching • Relieve pain • Allergic reactions require medical referral. Buff W, Powell P. Insect Bites and Stings and Pediculosis. In: Krinsky DL, Handbook of nonprescription drugs . 17 th ed. Washington DC: American Pharmacist’s Association; 2012; 675-691.

10/21/2016 7 Establish appropriateness of Self-Care of Insect Stings Exclusion Soft Hard Hives, excessive swelling, dizziness, weakness, N&V, difficulty breathing Significant allergic response away from the sting Previous sting by honeybee, wasp, or hornet Previous severe reaction Personal or family history of significant allergic reaction <2 years of age Buff W, Powell P. Insect Bites and Stings and Pediculosis. In: Krinsky DL, Handbook of nonprescription drugs . 17 th ed. Washington DC: American Pharmacist’s Association; 2012; 675-691. Nonpharmacologic Therapy • Remove stinger • After removal an antiseptic should be applied • Alcohol • Hydrogen peroxide • Apply an ice pack in 10 minute intervals. • Helps slow absorption • Reduces itching, swelling, and pain • Avoid scratching the affected area. Buff W, Powell P. Insect Bites and Stings and Pediculosis. In: Krinsky DL, Handbook of nonprescription drugs . 17 th ed. Washington DC: American Pharmacist’s Association; 2012; 675-691. Pharmacologic Therapy • Local anesthetics* • Antihistamines* • Counterirritants* • Anti-inflammatory Agent* • Skin Protectants* *Refer to insect bite section Buff W, Powell P. Insect Bites and Stings and Pediculosis. In: Krinsky DL, Handbook of nonprescription drugs . 17 th ed. Washington DC: American Pharmacist’s Association; 2012; 675-691. Epinephrine Trade name Active Ingredient MOA Directions Adverse Effects Notes EpiPen Auto- Injector Epinephrine 0.3mg α1, β1, β2 agonist Remove safety release. Grasp in fist and inject into middle of outer thigh at a 90 degree angle. Hold firmly for 10 seconds before removing. Palpitations Sweating Tremor Anxiety Restlessness Routinely check expiration date.