Adrenaline
Adrenaline is the drug of choice for the emergency treatment of severe allergic reactions to food, insect stings, medication, latex, exercise, and other allergens.25,29,36,37.. It should be administered as soon as the diagnosis of anaphylaxis is suspected, as there is clear evidence that failing to do so has contributed to fatal outcomes. A 2008 Cochrane review concluded that most people dying from anaphylaxis had not received prompt adrenaline treatment. Delayed injection of adrenaline can also increase the likelihood of a biphasic reaction.
If there is any doubt, it is generally better to administer adrenaline.
Adrenaline rapidly treats all of the most dangerous symptoms of anaphylaxis, including throat swelling, difficulty breathing, and low blood pressure. It also helps alleviate itching, rash, swelling, gastrointestinal and genitourinary symptoms. It works most effectively if it is given within the first few minutes of a severe allergic reaction.
Mean time to peak plasma concentrations of adrenaline is 8±2 minutes after administration.38 This is important as respiratory or cardiac arrest can occur as early as 6 minutes for food-triggered reactions and 4 minutes for venom-triggered reactions (median times 30 and 15 minutes, respectively).
- 25 - Resuscitation Council (UK) Guidelines. January 2008.
Available at: www.resus.org.uk/pages/reaction.pdf Accessed on 03 June 2011. - 29 - Sheikh A, Shehata YA, Brown SGA, et al. Cochrane Database Syst Rev. 2008; Issue 4: CD006312.
- 36 - McLean-Tooke APC, Bethune CA, Fay AC, et al. BMJ 2003;327:1332–1335.
- 37 - Muraro A, Roberts G, Clark A, et al. Allergy 2007;62:857–871.
- 38 - Simons FER et al. J Allergy Clin Immunol 1998;101(Part 1):33-7.