Name: RAFAEL, DUNE VIENIS KAREN N.

Year & Section: BS-

Pharmacy 4A
Group No.: ______________________ Date Started: November
27, 2009
Date Submitted: December 07,
2009

Exercise No. 07
PREPARATION OF PENICILLIN G SKIN TESTING

I. Objectives:
i. To prepare Penicillin G sodium for skin testing,
ii. To identify the possible skin reactions in positive skin testing,
and
iii. To enumerate the measures in managing anaphylactic shock
during skin testing.

I. Data Output:
Labeling:

Saint Luke’s Hospital

Father Selga Street, Davao City
Patient’s Name: Robert John R. Rafael Age: 23 Sex: Male
Attending Physician: J. Noveno, MD. Room No.: 47

Penicillin G
120 units/ 0.02 ml solution for Skin Testing

Prepared by: Dune Rafael, RPh

Pharmacist

II. Answers to Questions:

1. If the patient has mentioned in the medication history about allergy to
penicillin, what are the ways to be done if the doctor has accidentally
prescribed penicillin?

One way is to inform the physician that the patient is allergic to

penicillin. By that way, the physician could prescribe another drug.

2. How is a positive skin test translated?

Intradermal skin testing consisted of intradermal injection of

approximately 0.02 mL of the antigens and control solutions into
sequential, premarked skin sites. The test results were considered positive
if a wheal and flare reaction larger than that of the negative control was
present during prick or intradermal testing either for BPP or penicillin G.
The total time required to perform the test is approximately 30 min.
Patients who were receiving histamine-2 blockers had the medication held
at least 4 h before the skin test [Medscape].

3. What are some methods done if the patients suddenly have anaphylactic
shock while performing skin test?
 There is only one rapidly effective treatment for anaphylaxis –
epinephrine by injection. Epinephrine is adrenaline and it rapidly reverses
anaphylactic symptoms. It is typically given through an automatic
injection device. The most common injection site is the thigh [WebMD,
2009].

In addition to epinephrine, treatment for shock includes

intravenous fluids and medicines that support the actions of the heart
and circulatory system. After a person in shock is stabilized,
antihistamines and steroids may be given to further reduce symptoms
[WebMD, 2009].

I. Conclusion
Penicillin skin testing is an accurate method to determine whether
a person with a history of penicillin allergy is at risk of having an
immediate reaction to penicillin. A patient with a negative reaction to a
skin test may be able to use a penicillin compound safely, which could
reduce the use of broad-spectrum antibiotics in this patient population.

II. Bibliography

Medscape. (n.d.). A pilot Study of Penicillin Skin Testing: Materials and Methods.
Retrieved December 5, 2009, from Medscape.com:
http://www.medscape.com/viewarticle/405960_2

WebMD. (2009, February 05). Allergies and Anaphylaxis. Retrieved December 05,
2009, from WebMD.com: http://www.webmd.com/allergies/guide/anaphylaxis