Twenty minutes after taking amoxicillin, a patient develops generalized hives, wheezing and a blood pressure of 80/50 mm Hg. What is the most appropriate first drug to administer?
- Correct answer
Epinephrine 1 mg/mL intramuscularly into the anterolateral thigh
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Diphenhydramine orally
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Salbutamol by metered-dose inhaler
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Hydrocortisone intravenously
This question is one of 15 in AFK practice: Pharmacology, local anesthesia and emergencies. Test yourself on all of them.
Practice quiz FlashcardsExplanations
Hypotension and bronchospasm with urticaria indicate anaphylaxis, for which intramuscular epinephrine is the first-line drug: 0.01 mg/kg of the 1 mg/mL solution into the anterolateral thigh, up to a maximum single dose of 0.5 mg in adults, repeated every 5 to 15 minutes if needed. Antihistamines, inhaled bronchodilators and corticosteroids are adjuncts that do not reverse the life-threatening signs.
Source: Malamed, Medical Emergencies in the Dental Office; CSACI position statement on epinephrine autoinjectors (2021) link — oneguy
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