[NP-Clinical] Help with Hives update

[Andy Craig]

If she's been on all those antibiotics and isn't getting any better--maybe
it's a virus.  How about trying just mucolytics, decongestants, maybe some
Afrin nasal spray, warm compresses to the face, and tincture of time?
 
About 10-20% of people who are allergic to PCN have a cross-reaction to
cephalosporins, so that's why the caution.
 
Andy Craig, NP
Charlotte, NC

-----Original Message-----
From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net]
On Behalf Of Kathleen
Sent: Friday, January 19, 2007 10:48 PM
To: np-clinical at nurse.net
Subject: [NP-Clinical] Help with Hives update


My 15 yo daughter completed a Z pack last Monday, the 15th, still has
urticaria welts that are itchy but fade rather quickly with Benadryl on
board. Still has cough, some nasal congestion. Lungs clear. Doc prescribed
Zyrtec 10 mg qd for hives and Ceftin 500 mg bid for continuing sinus
infection today (to start tomorrow for ten days, after five days on the Z
pack, and 10 days on Amoxicillin). She has had no blood work (even though I
suggested it) or films or cultures done. No hives tonight with only one dose
of Benadryl today.  Doc did not palpate sinuses, just looked in nose (and
asked about allergies to pets, asthma...brother) and mouth and said she had
a lot of drainage. Is not concerned about mono, no lymph nodes are swollen.
I asked about diarrhea and doc suggested eating yogurt. Wants to see her on
Monday if she develops a "rash or hives that won't go away". According to my
drug information, Ceftin should be used with caution in a PCN allergy and
that a culture should be done before prescribing. Thoughts????
Kathleen, Psych. NP



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