Optimizing Adrenaline Administration in Anaphylaxis: Clinical Practice Considerations and Safety Insights.

IF 4 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2025-08-01 DOI:10.1002/clt2.70085

Motohiro Ebisawa, Antonella Muraro, Margitta Worm, Constance H Katelaris, Guillaume Pouessel, Johannes Ring, George Du Toit, Adam T Fox

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引用次数: 0

Abstract

Background: Anaphylaxis is an acute, severe, and potentially fatal reaction marked by the fast onset of symptoms and organ involvement that may lead to death from vascular collapse or airway obstruction. Despite adrenaline (epinephrine) being the first-line medication for reversing anaphylactic symptoms, misconceptions about its safe and correct use persist and lead to improper administration.

Methods: This review provides a comprehensive overview of clinical use of adrenaline autoinjectors (AAIs) in the management of anaphylaxis, key safety considerations, and pharmacokinetic/pharmacodynamic profile of three of the currently marketed AAIs.

Results: When administered intramuscularly (IM) at the recommended dose for anaphylaxis, adrenaline is considered safe; however, adequate training in emergency care is essential to minimize dosage errors and mitigate safety risks. In specific situations, such as refractory anaphylaxis, intravenous (IV) administration is advised under specialized settings due to the potential risk of severe cardiovascular complications that can result from dosing errors.

Conclusion: Although adrenaline can cause mild and transient side effects even when administered correctly at the recommended dosage, the potential side effects should not deter its use in critical situations such as anaphylaxis. This review aims to highlight the role of AAIs in improving patient outcomes during anaphylactic emergencies.

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优化过敏反应的肾上腺素管理：临床实践考虑和安全见解。

背景：过敏性反应是一种急性、严重和潜在致命的反应，其特征是症状迅速发作和器官受累，可导致血管塌陷或气道阻塞导致死亡。尽管肾上腺素（肾上腺素）是逆转过敏症状的一线药物，但对其安全性和正确使用的误解仍然存在，导致给药不当。方法：本综述全面概述了肾上腺素自体注射器（AAIs）在过敏反应管理中的临床应用，主要的安全注意事项，以及目前上市的三种AAIs的药代动力学/药效学概况。结果：当以推荐剂量肌注（IM）治疗过敏反应时，肾上腺素被认为是安全的；然而，充分的急救培训对于最大限度地减少剂量错误和减轻安全风险至关重要。在特殊情况下，如难治性过敏反应，建议在专门情况下静脉（IV）给药，因为剂量错误可能导致严重心血管并发症的潜在风险。结论：即使按推荐剂量正确使用，肾上腺素也会引起轻微和短暂的副作用，但潜在的副作用不应阻止其在过敏反应等危急情况下的使用。这篇综述的目的是强调在过敏性紧急情况下，AAIs在改善患者预后方面的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.