Remarks: Whether the drug requires skin testing and the preparation method of the skin test solution used, please follow the instructions. In principle, the original drug is used for skin testing.

1. 800,000 U/bottle of penicillin: 50u

Dissolve 800,000 U of penicillin in physiological saline to 4 ml; (200,000 U/ml)

Take up Add 0.1ml of normal saline to 1ml; (20,000 U/ml)

Take 0.1ml of supernatant and bring to 1ml of normal saline; (2,000U/ml)

Take 0.25 of supernatant ml normal saline to 1ml; (500U/ml)

Take 0.1ml of the supernatant for skin test (i.e. 50U)

2. Ampicillin 1g/bottle, cloxacillin 1g/ Bottle, ampicillin sodium, cloxacillin sodium 1g/bottle, azlocillin and sulbactam sodium 1g/bottle:

Add physiological saline to dissolve the above required drugs to 4ml; (250mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (25mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (2.5mg/ml)

Take Add 0.2ml of the upper solution to normal saline to 1ml; (0.5mg/ml)

Take 0.1ml of the upper solution for a skin test (i.e. 0.05mg)

The skin test results are judged the same as penicillin.

3. Ampicillin sodium and cloxacillin sodium 2g/bottle

Add physiological saline to dissolve the above required drugs to 8ml; (250mg/ml)

Take Add 0.1ml of the upper solution to normal saline to 1ml; (25mg/ml)

Take 0.1ml of the upper solution and bring to 1ml of normal saline; (2.5mg/ml)

Take 0.2ml of the upper solution to normal Saline to 1ml; (0.5mg/ml)

Take 0.1ml of the supernatant for skin test (i.e. 0.05mg)

The skin test results are judged the same as penicillin.

4. Mezlocillin and sulbactam sodium 1.25g/bottle

Add physiological saline to dissolve the above required drugs to 5ml; (250mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (25mg/ml)

Take 0.1ml of the upper fluid and adjust the normal saline to 1ml; (2.5mg/ml)

Take 0.2ml of the upper fluid Normal saline to 1ml; (0.5mg/ml)

Take 0.1ml of the supernatant for skin test (i.e. 0.05mg)

The skin test results are judged the same as penicillin.

5. Amoxicillin and sulbactam sodium 1.5g/bottle, paracillin and sulbactam sodium 1.5g/bottle

Add physiological saline to dissolve the above required drugs to 6ml ; (250mg/ml)

Take 0.1ml of the upper solution and normal saline to 1ml; (25mg/ml)

Take 0.1ml of the upper solution and normal saline to 1ml; (2.5mg/ml )

Take 0.2ml of the upper solution and normal saline to 1ml; (0.5mg/ml)

Take 0.1ml of the upper solution for skin test (i.e. 0.05mg)

Skin test results are judged the same as penicillin.

6. Mezlocillin 0.5g/bottle, paracillin 0.5g/bottle, ampicillin 0.5g/bottle

Add physiological saline to dissolve the above required drugs to 2ml; ( 250mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (25mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (2.5mg/ml)

Take 0.2ml of the upper solution and normal saline to 1ml; (0.5mg/ml)

Take 0.1ml of the upper solution for skin test (i.e. 0.05mg)

Skin The test results are the same as penicillin.

7. Long-acting cillin (benzathine penicillin) 1.2 million U/bottle:

Dissolve 5.8 ml of long-acting cillin in normal saline; (200,000 U/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (20,000 U/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (2,000U/ml)

Take 0.25ml of the upper solution and normal saline to 1ml; (500U/ml)

Take 0.1ml of the upper solution for skin test (i.e. 50U/0.1ml)

The skin test results are judged in the same way penicillin.

8. Procaine:

Procaine 40mg/tube, concentration is 0.25;

Take 0.125ml normal saline to 1ml;

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Take 0.1ml of the supernatant for skin test (i.e. 0.25mg)

The skin test results are judged the same as penicillin.

9. Pioneer bismuth 1g/bottle, ceftezole 1g/bottle:

Add physiological saline to dissolve the above required drugs to 4ml; (250mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (25 mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (2.5mg/ml)

Take the upper Solution 0.2ml normal saline to 1ml; (0.5mg/ml) (500ug/ml)

Take 0.1ml (i.e. 50ug/0.1ml) for skin test

Judgment of skin test results Same as penicillin.

10. Cefradine 0.5g/bottle, cefuroxime sodium 0.5g/bottle, cefodizime sodium 0.5g/bottle, cefoperazone sodium and sulbactam sodium 0.5g/bottle, cefazolin sodium 0.5g/bottle:

Add the above required drugs to 2ml with normal saline; (250mg/ml)

Take 0.1ml of the supernatant and add normal saline to 1ml; (25 mg/ml )

Take 0.1ml of the upper fluid and normal saline to 1ml; (2.5mg/ml)

Take 0.2ml of the upper fluid and normal saline to 1ml; (0.5mg/ml) (500ug/ ml)

Take 0.1ml (i.e. 50ug/0.1ml) during skin test

The skin test results are judged the same as penicillin.

11. Ceftriaxone 1.5g/bottle, ceftriaxone-sulbactam sodium 1.5g/bottle

Add physiological saline to dissolve the above required drugs to 6ml; (250mg/ml )

Take 0.1ml of the upper fluid and normal saline to 1ml; (25 mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (2.5mg/ml)

Take 0.2ml of the upper solution and normal saline to 1ml; (0.5mg/ml) (500ug/ml)

Take 0.1ml (i.e. 50ug/0.1ml) for skin test

Skin test results are judged the same as penicillin.

12. Ceftazidime and sulbactam sodium 0.75g/bottle

Add physiological saline to dissolve the above required drugs to 3ml; (250mg/ml)

Take 0.1ml of the upper fluid and normal saline to 1ml; (25 mg/ml)

Take 0.1ml of the upper fluid and bring the normal saline to 1ml; (2.5mg/ml)

Take 0.2 of the upper fluid ml normal saline to 1ml; (0.5mg/ml) (500ug/ml)

Take 0.1ml (i.e. 50ug/0.1ml) for skin test

The skin test results are judged the same as penicillin .

13. Tetanus antitoxin (TAT) 1500 U/tube: (Textbook)

Take 0.1ml of the supernatant and normal saline to 1ml; (150U/ml)

Take 0.1ml of the upper fluid for skin test; (i.e. 15U)

Observe the result for 20 minutes. If it is negative, it can be injected once. If it is positive, desensitization therapy will be performed.

Negative: No local redness, swelling, or abnormal reaction.

Positive: The skin is red and swollen, the diameter of the induration is greater than 1.5cm, the diameter of the red area is greater than 4cm, sometimes pseudopods or itching are present, and the systemic allergic reaction is roughly the same as the penicillin allergic reaction.

Desensitization therapy method:

First time: Take TAT0.1ml saline to 1ml for intramuscular injection;

Second time: Take TAT0.2ml physiological saline Add saline to 1ml for intramuscular injection;

Third time: Take TAT0.3ml of normal saline to 1ml for intramuscular injection;

Fourth time: Take the remaining normal saline to 1ml for intramuscular injection.

Inject every 20 minutes, and closely observe the patient's reaction during the desensitization process. If the patient has shortness of breath, pale complexion, cyanosis, urticaria, dizziness, heartbeat and other discomforts, the injection should be stopped immediately and treated as quickly as possible and reported to the doctor.

14. Cytochrome C 15mg/tube/2ml:

Take 0.1ml of cytochrome C and normal saline to 1ml; (0.75mg/ml)

Take the upper 0.1ml of liquid for skin test (i.e. 0.07mg)

Partial redness and swelling, diameter greater than 1cm, and papules are positive

15. Streptomycin 1g (1 million U/bottle) :

Add 1 million U of streptomycin and normal saline to 3.5ml (***4ml) (250,000 U/ml)

Take 0.1ml of the supernatant and add normal saline to 1ml; ( 25,000 U/ml)

Take 0.1ml of the upper solution and normal saline to 1ml; (25 million U/ml)

Take 0.1ml of the upper solution for skin test (i.e. 2500U)

(Skin test results are judged the same as penicillin. Streptomycin anaphylactic shock rescue measures are the same as penicillin anaphylactic shock rescue measures, because streptomycin can combine with calcium ions and chromium, thereby alleviating the toxic symptoms of streptomycin. or disappear. Therefore, it is necessary to prepare 10 calcium gluconate injection for intravenous injection)

16. Chymotrypsin 4000U/bottle

Chymotrypsin 4000U/bottle dissolved in 5ml of normal saline; (800U/ml )

Take 0.5ml of the upper solution and normal saline to 1ml; (40U/ml)

Take 0.1ml of the upper solution for skin test (i.e. 4U)

( Skin test is required for intramuscular injection; skin test results are judged the same as penicillin)

17. B1 injection 10mg/bottle/2ml

Take 0.1ml of the upper solution of normal saline to 1ml; ( 0.5mg/ml)

Take 0.1ml of the supernatant for skin test (0.05mg/ml)

(Skin test results are judged the same as penicillin)

18. Tuberculin 50U/tube/ml

Take 0.1ml of the upper solution for skin test (5U/ml)

During the skin test, inject test sensitivity solution into the left hand and physiological saline into the right hand. Contrast. 48-72 hours observation results

Negative: skin induration less than 5mm

Positive: skin induration 5-10mm ( )

Skin induration 10-15mm ( )

Skin induration 15-20mm ( )

Skin induration greater than 20mm or local blisters or necrosis is considered to be ( )

It should be explained to the patient that a positive tuberculosis test only requires Indicates that there has been tuberculosis

19. Iodine allergy test: (30 grams of diatrizoate meglumine) (all those who have angiography must do this test)

A. Take 60 grams of diatrizoate meglumine (European Parker) 0.5ml, add normal saline to 1ml and inject slowly intravenously.

B. Slow intravenous injection of special 30% diatrizoate meglumine test sensitizer (1ml).

Observe closely for 15 minutes. If the patient has nausea, vomiting, numbness in the hands and feet and/or urticaria, it is a positive reaction.

20. Salmon Calcitonin Injection 50 units (10μg/tube)

1. Take 0.2ml of the original solution from a 1ml syringe and dilute it to 1ml with normal saline;

2. Take 0.1ml (i.e. 1 unit) of the upper solution and inject it subcutaneously.

Observe for 15 minutes to see the results. The results are judged to be the same as those for penicillin.

21. Tetanus antitoxin (TAT) 1500 units/tube (current instructions require)

1. 0.1ml antitoxin plus 0.9ml sodium chloride injection,

2. Take 0.05ml of the upper solution and inject it intradermally on the forefoot side.

Observe for 30 minutes to see the results. Result judgment: Negative: If there is no obvious reaction at the injection site, antitoxin can be injected directly under close observation. Positive: The injection site appears enlarged, red, swollen, and infiltrated, especially if it looks like pseudopods or feels itchy.

Tetanus antitoxin desensitization therapy method:

Dilute 0.2ml of TAT stock solution to 2ml, subcutaneously inject small amounts several times, and observe for 30 minutes after each injection;

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The first time: take 0.2ml of the upper fluid and inject it subcutaneously. If there is no cyanosis, asthma or obvious shortness of breath, or accelerated pulse, the second time can be injected;

The second time: take the upper fluid 0.4ml subcutaneous injection, if there is no reaction, the third injection can be performed;

Third time: Take 0.8ml of the supernatant and subcutaneously inject it, if there is no reaction, the fourth injection can be performed

Fourth time: Take all remaining liquid (containing the full amount of undiluted antitoxin in the ampoule) for subcutaneous or intramuscular injection.

Those with a history of allergies or strongly positive allergy tests should appropriately reduce the first injection volume and subsequent incremental amounts and inject in divided doses to avoid severe reactions. Outpatients must be observed for 30 minutes after injection before leaving.

Penicillin allergy test method:

1. Assessment:

1) Carefully inquire about the history of allergy. If there is a history of penicillin allergy, stop the test. People with a history of allergies to other drugs or allergic diseases should use with caution.

2) If you have used penicillin before and then use it again after stopping the drug for 3 days (TAT 7 days), or if you change the preparation of a different batch number during use, you need to repeat the skin test and confirm that the result is negative before you can continue to use the drug. .

2. Plan:

1) Material preparation: 0.1 epinephrine hydrochloride is required (others omitted)

2) Patient preparation: A. Patient It is not advisable to perform skin tests on an empty stomach because some people may experience dizziness, nausea and other reactions when taking injections on an empty stomach, which should be confused with allergic reactions. B. Let the patient understand the purpose of the injection and not leave at will during the observation period; do not scratch or rub the skin test area; inform medical staff at any time if there are any abnormalities.

3. Implementation:

1) Preparation method (omitted)

2) Intradermal test: Inject 0.1ml of skin test solution intradermally on the inner side of the forearm. Observe the skin test results after 20 minutes. Criteria for judging skin test results:

Negative: There is no change in the skin, no redness and swelling around it, no blush, and no subjective symptoms.

Positive: The skin bulge increases, redness appears, the diameter is greater than 1cm, there are pseudopods around and local itching; in severe cases, dizziness, palpitation, nausea, and even anaphylactic shock may occur.

3) Those with positive skin test results cannot use penicillin, and this must be noted in the medical record, doctor's order, bedside card and injection form, and the results must be informed to the patient and their family members. If there is any doubt about the skin test result, 0.1 ml of normal saline should be injected into the contralateral forearm as a control, and the penicillin skin test result should be confirmed to be negative before the drug can be used.

First aid measures for anaphylactic shock:

1. Stop the medication immediately and make the patient lie down.

2. Immediately subcutaneously inject 1ml of 0.1 epinephrine, the dosage should be reduced for children. If the symptoms are not relieved, 0.5ml of the drug can be injected subcutaneously or intravenously every half hour. until out of danger period.

3. Give oxygen inhalation to improve hypoxia symptoms. When breathing is suppressed, artificial respiration should be performed immediately and respiratory stimulants should be used. When laryngeal edema causes suffocation, a tracheotomy should be performed as soon as possible.

4. Inject 5-10 mg of dexamethasone intravenously according to the doctor’s instructions, and use antihistamines, such as promethazine hydrochloride, etc.

5. Intravenous infusion of 10% glucose solution or balanced solution to expand blood volume. If the blood pressure still does not rise, dopamine can be added as directed by the doctor.

6. If cardiac arrest occurs, perform resuscitation immediately.

7. Observe the patient’s condition closely and record changes in the patient’s breathing, pulse, blood pressure, consciousness, and urine output