The use of epinephrine in the treatment of older adult asthmatics

Cydulka, Rita K.; Davison, Richard; Grammer, Leslie C.; Parker, Michele; Mathews, James

doi:10.1016/s0196-0644(88)80772-8

Cited by 52 publications

(18 citation statements)

References 26 publications

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“…There is no absolute contraindication to epinephrine administration in anaphylaxis. 44,45 Absorption is more rapid and plasma levels are higher in children not experiencing anaphylaxis who receive epinephrine intramuscularly in the thigh with an autoinjector. 46 Intramuscular injection into the thigh (vastus lateralis) in adults not experiencing anaphylaxis is also superior to intramuscular or subcutaneous injection into the arm (deltoid), neither of which achieves increased plasma epinephrine levels compared with endogenous levels.…”

Section: Management Of Anaphylaxismentioning

confidence: 99%

“…59 Corticosteroids administered during anaphylaxis might provide additional benefit for patients with asthma or other conditions recently treated with corticosteroids. 45 If given, intravenous corticosteroids should be administered early in the treatment of anaphylaxis at a dosage equivalent to 1.0 to 2.0 mg/kg/d of methylprednisolone every 6 hours. Oral administration of prednisone, 0.5 mg/ kg, might be sufficient for milder attacks.…”

Section: Management Of Anaphylaxismentioning

confidence: 99%

See 1 more Smart Citation

The diagnosis and management of anaphylaxis: An updated practice parameter

Lieberman¹,

Kemp²,

Oppenheimer³

et al. 2005

Journal of Allergy and Clinical Immunology

459

254

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Section: Management Of Anaphylaxismentioning

confidence: 99%

Section: Management Of Anaphylaxismentioning

confidence: 99%

The diagnosis and management of anaphylaxis: An updated practice parameter

Lieberman¹,

Kemp²,

Oppenheimer³

et al. 2005

Journal of Allergy and Clinical Immunology

459

254

View full text Add to dashboard Cite

“…A 1988 study of 95 patients who received epinephrine for ASA showed no clinically important arrhythmias in the over 40 age group and 2 episodes of accelerated idioventricular rhythm in the younger group. The authors concluded that epinephrine was safe for use in all age groups [69].…”

Section: Parenteral Beta-adrenergicsmentioning

confidence: 97%

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

Tennyson

2015

Curr Emerg Hosp Med Rep

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Asthma is an episodic disease of the airways characterized by inflammation and constriction of the bronchi. It has a significant societal impact with over 25 million persons affected in the United States alone and annually accounts for approximately 3300 deaths in the US. Standard therapy for acute severe asthma is effective for most patients, but controversies exist surrounding the care of the impending or actual respiratory failure patient. Non-invasive positive pressure ventilation has been effective in multiple case reports, but lacks large trial evidence to support its use. Intravenous ketamine similarly has supporting case reports, but an absence of rigorous evidence. Finally, parenteral beta-adrenergic medications have a long history of use, but have not been consistently shown to be superior to inhaled short-acting beta agonists. Further, they have been associated with higher rates of adverse effects.

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“…44 Known cardiac disease and age greater than 40 are relative contraindications to parenteral therapy; however, a study of 95 asthmatic patients without recent myocardial infarction concluded that subcutaneous epinephrine is tolerated well in adults >40 years. 45 …”

Section: Bronchodilatorsmentioning

confidence: 99%

Analytic Review: Management of Life-Threatening Asthma in Adults

Mannam

Siegel

2010

J Intensive Care Med

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Asthma remains a troubling health problem despite the availability of effective treatment. A small but significant number of asthmatics experience life-threatening attacks culminating in intensive care unit admission. Standard treatment includes high dose systemic corticosteroids and inhaled bronchodilators. Patients with especially severe attacks may develop respiratory failure and need endotracheal intubation and mechanical ventilation. Severe airway obstruction may lead to dynamic hyperinflation and the possibility of hemodynamic collapse and barotrauma. Fortunately, most intubated asthmatics survive if physicians adhere to key management principles intended to avoid or minimize hyperinflation. The purpose of this review is to discuss the pathogenesis of life-threatening asthma and to provide practical guidance to promote rationale, safe, and effective management.

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The use of epinephrine in the treatment of older adult asthmatics

Cited by 52 publications

References 26 publications

The diagnosis and management of anaphylaxis: An updated practice parameter

The diagnosis and management of anaphylaxis: An updated practice parameter

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

Analytic Review: Management of Life-Threatening Asthma in Adults

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