Epinephrine and its Use in Anaphylaxis: Current Issues

Keith J. Simons; F. Estelle R. Simons


Curr Opin Allergy Clin Immunol. 2010;10(4):354-361. 

In This Article

Future Role of Epinephrine in Anaphylaxis

No new medications for the treatment of an acute anaphylaxis episode are on the horizon. Novel epinephrine auto-injectors are in development,[43] as are novel epinephrine formulations for administration through noninvasive transcutaneous, intranasal, or sublingual routes.[50]

The World Health Organization (www.who.int) and the World Allergy Organization,[3] as well as all anaphylaxis guidelines,[4–6] state that epinephrine injection is fundamentally important in anaphylaxis management. Placebo-controlled trials of epinephrine are, therefore, clearly unethical. Recommendations for the maximum initial dose of epinephrine or the route of injection differ from one guideline to another; therefore, in the future, consideration might be given to the possibility of conducting randomized controlled trials comparing different first-aid epinephrine doses or different routes of injection.[51]


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