title: Allergic reaction to intranasal midazolam HCl: a case report.
abstract: An acute allergic reaction in a 5-year-old healthy male, after receiving midazolam by intranasal atomizer for sedation purposes in the dental clinic, was reported. Shortly after the midazolam was provided, the child developed urticaria in both ankles, which rapidly progressed to the lower extremities, stomach, back, arms, neck, and face. The periorbital skin also became edematous. In the emergency room, the diagnosis of an urticaria allergic reaction was confirmed. The child was treated with intramuscular diphenylhydramine, discharged from the emergency room after 5 hours, and prescribed oral diphenylhydramine (Benadryl) and prednisolone (Orapred). Children who receive sedatives such as midazolam in the dental clinic should be carefully monitored from the moment they receive the sedative, in order to disclose and treat undesirable side effects of the sedative agents as early as possible. The implications of allergic reactions to sedative agents in the dental clinic are reviewed.
authors.affiliation: Department of Pediatric Dentistry, University of Florida College of Dentistry, Gainesville, FL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: McIlwain
authors.forename: Robert
authors.initials: R
authors.lastname: Primosch
authors.forename: Enrique
authors.initials: E
authors.lastname: Bimstein
mesh_terms: D000281:Administration, Intranasal; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology*; D004487:Edema / Q000139:chemically induced; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008297:Male; D008874:Midazolam / Q000009:adverse effects*; D014581:Urticaria / Q000139:chemically induced* / Q000188:drug therapy
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam