Allergic reactions to antibiotics for patients with cystic fibrosis - Information for patients Pharmacy

Allergic reactions to
  antibiotics for patients
  with cystic fibrosis
            Information for patients
            Pharmacy

PROUD TO MAKE A DIFFERENCE
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST

Why have I been given an anaphylaxis kit?
All medicines can cause allergic reactions. The allergic reaction can
happen soon after you start taking the medicine or it can happen at any
time during treatment. You may even have taken a medicine many
times before without a problem. If you have had an allergic reaction to
a medicine you should not usually have the medicine again as the
allergic reaction can be more serious next time. However, in exceptional
circumstances and under the supervision of your consultant, the
medicine may be used again.
Allergic reactions range from mild to serious and can be life threatening.
Serious allergic reactions are rare, but it is important that they are
treated without delay.
You will need an anaphylaxis kit if you are having a course of
intravenous antibiotics at home. Once the course of antibiotics has
finished you can keep the kit for your next course. If you have an
anaphylaxis kit at home check the expiry date before starting antibiotics
as it has a short life span.

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What do I do if I think I'm having an allergic reaction?
What type of reaction is it?         What do I do?
Mild reaction:                       Stop the antibiotics and let the CF
Red itchy rash on arms, legs and     team know.
body.
You do not feel unwell.
Moderate reaction:                   Stop the antibiotics and take one
Rash as above with flushed           chlorphenamine (Piriton) 4mg
feeling and uncomfortable            tablet three times a day until the
itching, possibly blisters.          rash settles. Let the CF team
                                     know as soon as possible.
You feel slightly unwell.
Severe reaction:                     Dial 999 for immediate
Rash as above with swelling of       medical attention. Inject the
the face, tongue and lips,           adrenaline auto-injector into the
shortness of breath or wheezing.     thigh, take 12 (twelve)
                                     prednisolone 5mg tablets and 1
                                     chlorphenamine (Piriton) 4mg
                                     tablet. Contact the CF team
                                     immediately.

                      Cystic Fibrosis Team
                        0114 226 6580

What is an anaphylaxis kit?
An anaphylaxis kit contains:
  • An adrenaline (epinephrine) auto-injector syringe
  • A box of chlorphenamine 4mg tablets
  • A box of prednisolone 5mg tablets

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Adrenaline (epinephrine) auto-injector syringe
Examples are EpiPen®, Emerade®, Jext®. These are designed to be
used by people with no medical training.
Please ensure that you know how to use the device before starting your
antibiotic treatment. For instructions please read the manufacturer's
patient information leaflet in the packaging.
Only inject adrenaline into the outer thigh, do not inject in the
buttock as there is a risk of accidentally injecting into a vein.
A serious reaction is very rare. If you have a serious reaction, your
breathing and circulation can be affected.
Adrenaline works directly on the heart and lungs opposing the
potentially fatal anaphylaxis reaction by:

  • relaxing muscles in the           • helping circulation
    lungs to stop wheeze and          • preventing swelling
    improve breathing
  • stimulating the heart

Potential side effects
After using the adrenaline you may experience some of the following:

  •   rapid heartbeat                 •   nausea
  •   problems breathing              •   vomiting
  •   paleness, palpitations          •   nervousness
  •   sweating                        •   tremor

Do not worry and wait for the ambulance to arrive.

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Storage of adrenaline
Adrenaline is light sensitive and should be stored in its original container
at room temperature. Do not keep in the refrigerator. If you have an
anaphylaxis kit at home check the expiry date before starting antibiotics.

Chlorphenamine tablet
This is an antihistamine tablet used to relieve itchy skin reactions. It is
sometimes called Piriton®. One 4mg tablet should be taken three times
a day for a moderate reaction (further supplies are available from the
chemist or your GP). If you experience a severe reaction take one
chlorphenamine tablet immediately as directed and follow the earlier
instructions.
Potential side effects
Chlorphenamine tablets may make you sleepy. If this happens, do not
drive or use tools or machines. Do not drink alcohol.
Side effects are not common, but you may feel:
  •   a quick heart beat
  •   dizziness
  •   dry eyes and mouth
  •   diarrhoea or constipation
  •   difficulty in passing urine

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Prednisolone tablets
If you have a severe allergic reaction, take twelve (12) prednisolone 5mg
tablets, with a drink of water.
Prednisolone is a steroid and will reduce inflammation.
Potential side effects
Side effects are very rare with a single dose, but you may feel nauseous
or have indigestion.

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PD2649-PIL233 v6                                                     Issue Date: December 2019. Review Date: December 2022