Which of the following drugs will be administered in anaphylaxis?

RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Pharmacology

Easy

Appeared in: RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Explanation

Epinephrine is the first-line drug for treating anaphylaxis, a severe and potentially fatal systemic allergic reaction.
It acts rapidly on alpha and beta-adrenergic receptors to counteract the life-threatening manifestations of anaphylaxis.
The alpha-adrenergic action constricts blood vessels, reversing hypotension and reducing swelling (angioedema).
The beta-adrenergic action relaxes airway muscles (bronchodilation) to improve breathing and increases cardiac output.
It also helps prevent the further release of inflammatory mediators like histamine from mast cells.

Option A: Sodium bicarbonate is an alkalinizing agent used to treat severe metabolic acidosis, hyperkalemia, or certain drug overdoses. It has no role in treating the allergic mechanisms of anaphylaxis.
Option C: Atropine is an anticholinergic drug. Its primary use is to treat symptomatic bradycardia (an abnormally slow heart rate) or certain types of poisoning (e.g., organophosphate). It does not address the vasodilation or bronchoconstriction seen in anaphylaxis.
Option D: Digoxin is a cardiac glycoside used to increase the contractility of the heart muscle in patients with heart failure or to control the heart rate in atrial fibrillation. It is not used in the emergency management of allergic reactions.

Visual 1: Infographic: Step-by-step emergency management of anaphylaxis, highlighting the immediate administration of epinephrine.
Visual 2: Diagram: Illustrating the physiological effects of anaphylaxis (vasodilation, bronchoconstriction, edema) and how epinephrine's alpha and beta-adrenergic actions counteract these effects.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological management of anaphylaxis as background academic context rather than a clinical decision trigger.
Recognizing the signs of anaphylaxis (e.g., hives, angioedema, wheezing, hypotension) and acting quickly is a critical nursing responsibility. Delay in administering epinephrine is associated with increased mortality.
Nurses must know the correct dose, route (intramuscular in the vastus lateralis is preferred), and administration frequency for epinephrine in an emergency.
What if? If a patient experiencing anaphylaxis is on a beta-blocker, their response to epinephrine may be blunted. In such cases, glucagon may be administered as it has a positive inotropic and chronotropic effect on the heart that is not mediated by beta-receptors.

How to Approach the Question

First, identify the clinical condition presented in the question: 'anaphylaxis'.
Recall the definition of anaphylaxis as a life-threatening, systemic allergic reaction requiring immediate intervention.
Access your knowledge of emergency pharmacology and treatment protocols. The first-line, life-saving medication for anaphylaxis should come to mind.
Evaluate the options based on their primary mechanisms of action. Epinephrine is the only drug listed that directly counteracts the pathophysiology of anaphylaxis.
Eliminate the other options by identifying their primary indications (Sodium bicarbonate for acidosis, Atropine for bradycardia, Digoxin for heart failure).
Select the option that is the universally accepted first-line treatment for this specific emergency.

Concept Tested & Keywords

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