Which of the following drugs will be administered to treat anaphylaxis?

RRB Nsg. Superintendent-20 July 2019 (Shift-1)

Pharmacology

Easy

Appeared in: RRB Nsg. Superintendent-20 July 2019 (Shift-1)

Explanation

Epinephrine is the first-line, life-saving medication for anaphylaxis due to its rapid onset of action.
It acts on alpha-adrenergic receptors to cause vasoconstriction, which increases blood pressure and reduces airway edema.
It acts on beta-adrenergic receptors to cause bronchodilation, which opens the airways, and to increase the heart's rate and contractility.
Epinephrine also stabilizes mast cells, preventing the further release of histamine and other inflammatory mediators that drive the allergic reaction.

Option A: Sodium bicarbonate is a buffering agent used to correct metabolic acidosis. It has no role in treating the underlying mechanisms of an allergic reaction like vasodilation or bronchoconstriction.
Option C: Atropine is an anticholinergic drug. While it increases heart rate, it does not address the widespread vasodilation, increased capillary permeability, and bronchoconstriction that characterize anaphylaxis.
Option D: Digoxin is a cardiac glycoside with a slow onset of action. It is used for chronic heart conditions and has no effect on the acute inflammatory and cardiovascular collapse seen in anaphylaxis.

Visual 1: Diagram: Mechanism of action of Epinephrine, showing its effects on alpha-1 (vasoconstriction), beta-1 (increased heart rate/contractility), and beta-2 (bronchodilation) receptors.
Visual 2: Infographic: Signs and symptoms of anaphylaxis, categorized by system (respiratory, cardiovascular, skin, GI) to aid in rapid recognition.
Visual 3: Flowchart: Step-by-step emergency management of an adult with anaphylaxis, starting with recognition and administration of IM epinephrine.

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.
Rapid identification of anaphylaxis and immediate administration of intramuscular epinephrine are critical, time-sensitive nursing responsibilities that can be lifesaving.
Nurses must be proficient in administering epinephrine via an auto-injector or from a vial and must know the correct dose and injection site (mid-anterolateral thigh).
Following epinephrine administration, the nurse's role includes continuous monitoring of the patient's airway, breathing, circulation, and response to treatment, and preparing for potential second doses.

How to Approach the Question

First, identify the core clinical condition presented in the question, which is 'anaphylaxis'. Recognize this as a severe, life-threatening allergic reaction requiring immediate intervention.
Access your knowledge of emergency pharmacology. The question asks for the primary drug used to 'treat' this condition.
Systematically evaluate each option based on its main pharmacological action and primary clinical indication.
Option A (Sodium bicarbonate) is a buffer for acidosis. Option C (Atropine) is for bradycardia. Option D (Digoxin) is for heart failure. None of these directly address the pathophysiology of an allergic reaction.
Option B (Epinephrine) is a potent adrenergic agonist that directly counteracts the life-threatening effects of anaphylaxis: it constricts blood vessels to raise blood pressure, opens airways, and increases heart function.
Conclude that Epinephrine is the only drug listed that provides immediate and comprehensive treatment for anaphylaxis.

Concept Tested & Keywords

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