From the Guidelines
For bronchospasm, the recommended dose of epinephrine is 0.3-0.5 mg (300-500 micrograms) administered intramuscularly, which can be repeated every 5-15 minutes as needed, as stated in the most recent and highest quality study 1.
Key Points to Consider
- The dose of epinephrine for bronchospasm is based on the patient's weight, with a maximum dose of 0.3-0.5 mg (300-500 micrograms) for adults and 0.01 mg/kg (10 micrograms/kg) up to a maximum of 0.3 mg (300 micrograms) for children, as recommended by 1 and 1.
- Epinephrine can be administered via intramuscular injection, with the anterolateral thigh being the preferred site, as noted in 1.
- For severe cases of bronchospasm, continuous nebulized epinephrine at 1-5 mg (1000-5000 micrograms) diluted in 3 mL of normal saline can be used, although this is not the primary recommended treatment.
- When administering epinephrine, it is essential to monitor for potential side effects, including tachycardia, hypertension, tremors, and anxiety, as cautioned by 1 and 1.
- In patients with cardiovascular disease, epinephrine should be used with caution due to the risk of cardiac complications, as advised by 1.
Additional Considerations
- For patients with recurrent bronchospasm, consider additional bronchodilators such as albuterol or ipratropium bromide for maintenance therapy after the acute episode resolves, as suggested by 1.
- The use of antihistamines and corticosteroids should not be considered a substitute for epinephrine in the treatment of anaphylaxis or severe bronchospasm, as emphasized by 1.
From the Research
Epinephrine Dosage for Bronchospasm
- The provided studies do not specify the exact dosage of epinephrine for bronchospasm in micrograms 2, 3, 4, 5, 6.
- According to the studies, epinephrine is the first-line treatment for anaphylaxis, and its administration is critical for survival 2, 3, 4, 5.
- For patients with anaphylaxis, epinephrine should be administered intramuscularly, into the anterolateral thigh, as soon as the diagnosis is suspected 2.
- The studies suggest that β-adrenergic agonists by inhalation are indicated for bronchospasm associated with anaphylaxis despite optimal epinephrine treatment 3.
- There is no specific information on the dosage of epinephrine for bronchospasm in the provided studies, and it is recommended to follow established medical guidelines for the treatment of anaphylaxis and bronchospasm 2, 3, 4, 5, 6.