Mild reactions (urticaria, pruritus, limited flushing) are treated with diphenhydramine and observation. Moderate reactions (more diffuse urticaria, mild bronchospasm, throat tightness without airway compromise) add a corticosteroid and closer monitoring. Severe/anaphylactic reactions (laryngeal edema, hypotension, significant bronchospasm) require immediate epinephrine (IM 0.3–0.5 mg, or IV in a monitored, refractory case), airway support including possible intubation, aggressive IV fluids, and full code team activation. Reaction severity can escalate quickly, so early treatment of a seemingly mild reaction, along with close ongoing observation for delayed escalation, is essential.
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