From Rf

Aspirin desensitization is useful in diseases where low-level antiplatelet action is needed and in the care of patients with aspirin sensitivity and intractable nasal polyps. Lysine aspirin availability in Europe allows desensitization by inhalation at greatly reduced risk. New procedures utilizing ketorolac as a nasal topical application may allow similar reduction of risk in the United States.26 As with all desensitizations, constant daily administration must be maintained once the desired dose is reached. Table

54-8 summarizes several similar aspirin desensitization protocols. Table 54-9 depicts a 2-day alternative protocol.28

All desensitization procedures are expected to produce mild symptoms in the patient at some point, and the patient must be made to understand this before doses are started. Mild sensitivity to the drug still remains, and large dose increases as well as missing doses should be avoided. Late complications, such as urticaria, may occur with Type I desensitization, and serum sickness or hemolytic anemia may also occur with high-dose therapy in allergic, desensitized patients.

Table 54-7 Parenteral Penicillin Desensitization Protocol

Benzylpenicillin

Injection

Concentration

Volume

No.

(Units)

tmL)

(Route)

1

100

0.1

ID

2

100

0.2

SC

100

0.4

SC

4

too

0.8

sc

1,000

0.1

ID

6

1r000

0.3

SC

7

1,000

0.6

SC

3

10,000

0.1

ID

9

10,000

0.?

sc

io

10,000

0.4

SC

11

10,000

0.8

SC

12

100,000

0.1

ID

13

100,000

03

SC

14

100,000

0.6

SC

15

1,000000

0.1

ID

15

1,000,000

0.2

SC

U

1,000r000

0,2

IM

18

1,000,000

0.4

m

19

Continuous IV Infusion at 1000,000 units/h

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