Q: If there is no epinephrine available, could an albuterol inhaler be used until benedryl takes effect in anaphylaxis with respiratory distress?

Q: With respiratory distress in anaphylaxis, if no epinephrine is available could an albuterol inhaler be used until the benedryl takes effect?

Good question.

If the symptoms are isolated to the lower airways as manifested by wheezes, an inhaled Beta agonist like albuterol will probably help with the symptoms.  But remember that unlike asthma, anaphylaxis is a systemic, not a local, problem.  In anaphylaxis chemical mediators are released in the circulation and then migrate to sites around the body.  Albuterol works locally and will have no effect on the generation of these mediators.  If the manifestations are shock or upper airway obstruction (the two most lethal manifestations of anaphylaxis), the albuterol will not be useful.



3 Responses to “Q: If there is no epinephrine available, could an albuterol inhaler be used until benedryl takes effect in anaphylaxis with respiratory distress?”

  1. Bill McCuaig

    In reference to the comments about “if no epinhephrine is available could albuterol inhaler be use” I was wondering about a similar useage with an over the counter product available called “Primatene Mist”. It has been around along time. It is a Epinephrine Inhalation Aerosol Bronchodilator. The active ingredient is listed as “Epinephrine 0.22 mg”.

    Would any help be gained by using this product. Simple, cheap, easy to carry in a backpack. Or is the amount of Epinephrine in it just way to small to really help in an anaphylactic reaction.

  2. P.A.

    great question Bill, I am also interested to hear the answer. The adult IM dosage is .3mg @ 1/1000 from a twinject I believe. I wonder if the route or concentration in the Primatene is close enough to help (prior to total airway occlusion) ?

  3. Michael

    How does one treat anaphylactic shock if there is no epinephrine or medication is available?

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