What is the first-line medication in the management of anaphylaxis?

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Multiple Choice

What is the first-line medication in the management of anaphylaxis?

Prompt, intramuscular epinephrine is the first-line treatment for anaphylaxis. Epinephrine works on multiple receptors to rapidly reverse the dangerous features: alpha-1 causes vasoconstriction to raise blood pressure and reduce swelling; beta-1 strengthens heart output; beta-2 opens the airways and decreases mediator release from mast cells. Giving it by intramuscular injection in the mid-thigh ensures quick absorption with a safer profile than IV administration in most settings. Typical adult dose is 0.3–0.5 mg, and for children 0.01 mg/kg up to 0.3 mg, with repeats every 5–15 minutes as needed while monitoring. Diphenhydramine and albuterol may help with symptoms, but they do not address the life-threatening airway and circulatory compromise as promptly or effectively as epinephrine, so they are not first-line.

Prompt, intramuscular epinephrine is the first-line treatment for anaphylaxis. Epinephrine works on multiple receptors to rapidly reverse the dangerous features: alpha-1 causes vasoconstriction to raise blood pressure and reduce swelling; beta-1 strengthens heart output; beta-2 opens the airways and decreases mediator release from mast cells. Giving it by intramuscular injection in the mid-thigh ensures quick absorption with a safer profile than IV administration in most settings. Typical adult dose is 0.3–0.5 mg, and for children 0.01 mg/kg up to 0.3 mg, with repeats every 5–15 minutes as needed while monitoring. Diphenhydramine and albuterol may help with symptoms, but they do not address the life-threatening airway and circulatory compromise as promptly or effectively as epinephrine, so they are not first-line.

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