Hives --RN triage--

Better Worse

Hive-free >2wks Hive-free <2wks On H1Blockers?

Eliminate 2nd Continue present No Yes

dose of H1 blocker treatment until

hive-free >2wks,

then call office Add Allegra On H2 Blocker? Cimetadine (tagmet),

or Zyrtec Ranitidine (Zantac), Famotide (Pepcid)

Hive-free Hive-free one to two times

>2wks <2wks a day

No Yes

Stop H2 Continue treatment

Blockers until hive-free >2wks, Improved Not improved Add Zantac On hydroxyzine

then call office one to two or doxepin?

a day

Hive-free Hive-free Continue Call office

>2wks <2wks for 1-2wks No Yes

Stop Continue treatment Improved Not

doxepin until hive-free>2wks, improved

or then call office

hydroxyzine

Continue Call office

1-2wks

Hive-free

>2wks

Add Schedule OV or

doxepin task to MD to Stop H1 or hydroxyzine start steroid blockers--use prn only

Call office if worsens

or if hive free >2wks