Rønborg S M, Olsen O T, Heinig J H, Malling H J
RHIMA Centret, allergiklinikken, Rigshospitalet, København.
Ugeskr Laeger. 1996 Aug 5;158(32):4539-43.
Adrenaline is the drug of choice for the treatment of anaphylaxis. The indications, available formulations, and rules for prescribing adrenaline for self treatment of anaphylactic reactions in allergic subjects are summarized in this paper. Emergency kits containing adrenaline must be prescribed only to patients with a definite history of anaphylactic reactions or laryngeal oedema. A kit containing Adrenaline DAK 1 mg/ml in a traditional glass ampoule together with a 1 ml syringe and an i.m. cannula is the cheapest solution, and a usable alternative in the patient who after sufficient training feels safe to prepare his own injection. Ana-guard injector is recommended for the allergic adult due to its easy handling and the fact that it contains two doses of adrenaline 0.3 mg. For both children and adults with a low bodyweight, the Epi-Pen automatic injector is recommended. It contains one dose of adrenaline (0.15 or 0.30 mg) and requires no preparation before use. The Adrenalin Medihaler is recommended for the treatment of laryngeal oedema and threatened airway obstruction. Due to the low and unpredictable absorption after inhalation, adrenaline injection is recommended for the treatment of systemic symptoms. Prescribing adrenaline in semi-or automatic injectors requires special permission from the Danish Health Authorities.
肾上腺素是治疗过敏反应的首选药物。本文总结了过敏患者自行治疗过敏反应时肾上腺素的适应证、现有剂型及处方规则。仅应为有明确过敏反应或喉头水肿病史的患者开具含肾上腺素的急救药盒。传统玻璃安瓿中含1mg/ml肾上腺素DAK、1ml注射器及肌内注射套管的药盒是最便宜的选择，对于经过充分培训后感觉自行准备注射安全的患者来说是一种可用的替代方案。由于使用方便且含有两剂0.3mg肾上腺素，Ana-guard注射器推荐给成年过敏患者。对于儿童和低体重成人，推荐使用Epi-Pen自动注射器。它含有一剂肾上腺素（0.15或0.30mg），使用前无需准备。肾上腺素吸入器推荐用于治疗喉头水肿和有气道梗阻风险的情况。由于吸入后吸收低且不可预测，治疗全身症状时推荐使用肾上腺素注射剂。开具半自动或自动注射器中的肾上腺素需要获得丹麦卫生当局的特别许可。
