Individuals who have had insect sting anaphylaxis and have positive venom skin tests are at risk for further reactions after re-stings. Prophylactic measures include minimizing potential exposure, keeping medication for immediate treatment of anaphylaxis available, and consideration of VIT.
Measures that might minimize insect stings include wearing protective clothing when outside, such as shoes, slacks, long sleeves, and gloves. Cosmetics, perfumes, and black or drab clothing, which attract insects, should be avoided. Great care should be taken when eating outdoors because food and garbage do attract insects.
The primary medication for treatment of anaphylaxis is epinephrine. Individuals at potential risk should be given epinephrine, available in preloaded syringes, (Epi-Pen, Center Laboratories, Port Washington, NY; Twinject, Verus Pharmaceuticals Inc., San Diego, CA). Antihistamines, such as diphenhydramine, are also recommended and may be helpful for treatment of hives and edema.
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