Boswell Brittany, Rudders Susan A, Brown Julie C
Seattle Children's Hospital, Seattle, WA, USA.
Division of Emergency Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA.
Curr Allergy Asthma Rep. 2021 Mar 5;21(3):18. doi: 10.1007/s11882-021-00994-0.
Anaphylaxis is a severe, life-threatening, systemic allergic reaction that should be recognized and treated promptly. Intramuscular (IM) epinephrine is the first-line treatment for anaphylaxis and there are no absolute contraindications to its use. Despite its established track record of efficacy and safety, physicians and patients face barriers in the recognition and treatment of anaphylaxis, including the maintenance and appropriate use of epinephrine auto-injectors. This has led to investigation into potential alternatives to IM epinephrine administration in anaphylaxis.
This review investigates the current standard of care in the treatment of anaphylaxis, barriers to IM epinephrine use, and alternative therapies under investigation for administration in anaphylaxis. Alternative routes under investigation include intranasal, sublingual, inhaled, and needle-free intramuscular administration of epinephrine. There are currently numerous investigational alternatives to IM epinephrine therapy which could hold promise as future effective treatments in the emergent management of anaphylaxis.
过敏反应是一种严重的、危及生命的全身性过敏反应，应迅速识别并治疗。肌内注射肾上腺素是过敏反应的一线治疗方法，且其使用不存在绝对禁忌证。尽管肾上腺素在疗效和安全性方面有着既定的记录，但医生和患者在过敏反应的识别和治疗方面仍面临障碍，包括肾上腺素自动注射器的保存和正确使用。这促使人们对过敏反应中肌内注射肾上腺素的潜在替代方法展开研究。
本综述探讨了过敏反应治疗的当前护理标准、肌内注射肾上腺素使用的障碍以及正在研究的过敏反应替代治疗方法。正在研究的替代途径包括肾上腺素的鼻内、舌下、吸入和无针肌内注射。目前，有许多肌内注射肾上腺素疗法的替代研究方法，有望成为未来过敏反应紧急处理中的有效治疗方法。
