Song T Ted, Lieberman Phil
aUniversity of Washington, Department of Medicine, Division of Allergy and Infectious Diseases, Seattle, Washington bDepartment of Medicine & Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee, USA.
Curr Opin Allergy Clin Immunol. 2015 Aug;15(4):323-8. doi: 10.1097/ACI.0000000000000185.
The purpose of this manuscript is to review the literature in support of epinephrine (adrenaline) as first line of therapy of anaphylaxis, not H-1 antihistamines or corticosteroids.
The purpose of this review is to assess that epinephrine has a quick onset of activity and rapidly antagonizes multiple mediators that are active in anaphylaxis. Epinephrine has maximal pharmacodynamic effect within 10 min of intramuscular administration into the thigh. As epinephrine has a narrow therapeutic window, prefilled epinephrine auto-injectors are available. There are weight-appropriate doses of epinephrine available with auto-injectors that are prefilled with 0.15, 0.30 and 0.50 mg. In addition, needle lengths vary from 1.17 to 2.50 cm. Different doses and needle lengths are available for paediatric and adult patients, especially obese patients to ensure intramuscular delivery in the thigh.
Failure to administer epinephrine promptly has resulted in fatalities. Education about anaphylaxis and prompt treatment are critical for patients and their caregivers.
本文旨在回顾支持肾上腺素（副肾素）作为过敏反应一线治疗药物，而非H-1抗组胺药或皮质类固醇的文献。
本综述旨在评估肾上腺素起效迅速，能迅速拮抗过敏反应中多种活性介质。肌肉注射至大腿后，肾上腺素在10分钟内达到最大药效作用。由于肾上腺素治疗窗狭窄，已有预充式肾上腺素自动注射器。自动注射器有适合不同体重的剂量，预充有0.15、0.30和0.50毫克的肾上腺素。此外，针头长度从1.17至2.50厘米不等。针对儿科和成年患者，尤其是肥胖患者，有不同剂量和针头长度可供选择，以确保药物注射至大腿肌肉。
未能及时使用肾上腺素已导致死亡。对患者及其护理人员而言，开展过敏反应教育和及时治疗至关重要。
