Most important drug to control anaphylactic shock is?

Appeared in: BCCL kharkhanda Staff Nurse - 2015

Explanation

Adrenaline is the first-line, life-saving drug for managing anaphylactic shock as stated in treatment guidelines.
It acts rapidly on alpha- and beta-adrenergic receptors to counteract the life-threatening effects of anaphylaxis.
Its primary actions include vasoconstriction (alpha-1 effect), which increases blood pressure, and bronchodilation (beta-2 effect), which opens the airways and relieves respiratory distress.
Adrenaline also reduces swelling (angioedema) by decreasing vascular permeability.

Option A: Hydrocortisone is a corticosteroid with a slow onset of action (several hours). It cannot reverse the immediate life-threatening symptoms of anaphylaxis.
Option B: Dopamine is a vasopressor that is not the initial drug of choice for anaphylactic shock.
Option C: Dexamethasone is a potent, long-acting corticosteroid. Similar to hydrocortisone, its onset of action is too slow to be effective in the acute management of anaphylaxis.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing First-line drug therapy for anaphylactic shock in acute care settings.
Immediate administration of intramuscular adrenaline in the mid-outer thigh is a critical nursing action that can be life-saving. Any delay in administration significantly increases the risk of mortality.
Nurses must be proficient in recognizing the signs and symptoms of anaphylaxis (e.g., stridor, wheezing, hypotension, urticaria) and know the location and use of emergency adrenaline auto-injectors or kits.
What if? - If the patient is on a beta-blocker medication, their response to adrenaline may be blunted. In such cases of refractory anaphylaxis, glucagon may be administered as it can increase heart rate and contractility via a non-adrenergic pathway.

How to Approach the Question

First, identify the core of the question. It asks for the 'most important' drug, which points to a priority-based clinical decision.
Recognize that anaphylactic shock is a life-threatening emergency requiring immediate intervention.
Recall the standard treatment algorithm for anaphylaxis. The first and most critical step is administering the primary life-saving medication.
Evaluate the options based on their role and speed of action in anaphylaxis. Adrenaline acts within minutes to reverse life-threatening symptoms.
Eliminate the other options. Corticosteroids (Hydrocortisone, Dexamethasone) are second-line and slow-acting. Dopamine is a third-line agent for refractory shock. Therefore, Adrenaline is the only correct choice for immediate control.

Concept Tested & Keywords

Q6AGRiouNuX0aEjjIW0rRM

E6 Pharmacology Nurses Shanbhag 3e p. 83-85

E6 Pharmacology Katzung 16e p. 1548-1550

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Attempt every question from this paper in a timed mock, then review the full solution for each one.