Which is a common drug used during anaphylactic shock?

Appeared in: NORCET 2 - 2021 (shift-1)

Explanation

ADR/Epinephrine is the first-line and most critical drug in treating anaphylactic shock.
It acts as a physiological antagonist to the mediators of anaphylaxis, providing rapid relief of life-threatening symptoms.
Its alpha-1 agonist effect causes vasoconstriction, which increases blood pressure and reduces mucosal edema.
Its beta-1 agonist effect increases the heart's rate and force of contraction, improving cardiac output.
Its beta-2 agonist effect causes bronchodilation, relieving wheezing and shortness of breath.

Option B: Hydrocortisone is a corticosteroid with a slow onset of action (hours). It cannot reverse the immediate life-threatening symptoms of anaphylaxis.
Option C: Atropine is an anticholinergic agent and is not used to treat the primary symptoms of anaphylaxis like hypotension, bronchospasm, or airway edema.
Option D: Like hydrocortisone, dexamethasone is a corticosteroid with a slow onset. It is not effective for the immediate emergency management of anaphylaxis.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Pharmacological management of anaphylactic shock in acute care settings.
In anaphylaxis, time is critical. Any delay in administering epinephrine can lead to irreversible shock or death. Nurses must be able to recognize anaphylaxis and act immediately.
The correct route is intramuscular (IM) in the anterolateral thigh, as this provides rapid absorption. Subcutaneous injection is less effective.
What if? If a patient on a beta-blocker has anaphylaxis, they may have a blunted response to epinephrine. In this case, glucagon may be administered as it has a different mechanism to increase heart rate and contractility.

How to Approach the Question

First, identify the clinical condition in the question stem: 'anaphylactic shock'. This is a severe, life-threatening medical emergency.
Next, recall the standard of care and first-line treatment for this condition. The question asks for a 'common' drug, implying the most essential and frequently used medication.
Evaluate each option's primary pharmacological role. ADR/Epinephrine is a potent sympathomimetic used in cardiac arrest and anaphylaxis.
Consider the roles of the other options. Hydrocortisone and Dexamethasone are corticosteroids, which act slowly to reduce inflammation. Atropine is for bradycardia.
Differentiate between immediate, life-saving treatment and adjunctive (secondary) therapy. Corticosteroids are adjunctive, not primary.
Conclude that ADR/Epinephrine is the only option that rapidly reverses the life-threatening cardiovascular collapse and bronchoconstriction of anaphylaxis.

Concept Tested & Keywords

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Practise the full NORCET 2 - 2021 (shift-1)

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