Adrenaline (Epinephrine) in anaphylaxis case.

    

    As an alpha-receptor agonist, it reverses peripheral vasodilation and reduces oedema. 
    Its beta-receptor activity dilates the bronchial airways, increases the force of myocardial contraction, and suppresses histamine and leukotriene release. 
    There are also beta-2 adrenergic receptors on mast cells that inhibit activation, and so early adrenaline attenuates the severity of IgE-mediated allergic reactions. 





    Adrenaline seems to work best when given early after the onset of the reaction but it is not without risk, particularly when given intravenously. 
    Adverse effects are extremely rare with correct doses injected intramuscularly (IM) - Epipen. Sometimes there has been uncertainty about whether complications (e.g., myocardial ischaemia) have been caused by the allergen itself or by the adrenaline given to treat it.
    Difficulties can arise if the clinical picture is evolving when the patient is first assessed. Adrenaline should be given to all patients with life-threatening features.

    The intramuscular (IM) route is the best for most individuals who have to give adrenaline to treat an anaphylactic reaction. Monitor the patient as soon as possible pulse, blood pressure, ECG, pulse oximetry). This will help monitor the response to
adrenaline. 

    The IM route has several benefits:
• There is a greater margin of safety.
• It does not require intravenous access.
• The IM route is easier to learn.

     The needle used for injection needs to be sufficiently long to ensure that the adrenaline is injected into muscle.

read also: Epinephrine. Effects, Indications, Dosing.

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