AZbookworm

I do infusions of specialty medications in the home setting. Last week I had a patient who recieved her second dose of a biologic called Entyvio. I was not present for the first dose 2 weeks prior, but the report was that it went without adverse symptoms. Benadryl and tylenol were ordered as an oral premedication before the Entyvio infusion. The patient took the tylenol, but refused the benadryl. She wanted to drive her car after the infusion. About half way through the infusion, she experienced an allergic reaction. It was the beginning of a very slow anaphylactic reaction. She reported a numbness and fullness to the sides of her neck and tip of her tongue. As soon as she reported the symptoms to me I stopped the drip and administered PO benadryl. The reaction stopped before her swallowing or breathing became impaired. And then her symptoms improved. No epinepherine was required. As I discussed the reaction with her, she then remembered that she had the same reaction to shrimp within the last 2 months. Her ordering MD wants her to stay on this medication regimen. The premedications will be mandatory now. The next infusion is in 3 weeks. Would you feel comfortable giving the medication?