Anaphylaxis!

So in a nutshell, someone on a beta blocker having an anaphalactic reaction, and the Epi just ain't hitting it, Glucagon will help the Epi to do its job?
 
Cool!

As an atrial fib person, I'd appreciate anything other than epi! Even the epi in dental local anesthesia gives me even more tachy and palpitations, I can imagine an "Epipen" on board:wacko:.
 
I love this site! I am constantly looking up def's of words. I had to look up urticaria. I feel so dumb:unsure:
 
phideux said:
So in a nutshell, someone on a beta blocker having an anaphalactic reaction, and the Epi just ain't hitting it, Glucagon will help the Epi to do its job?
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Glucagon doesn't help epi do its job, it just works in a different way. It is able to accomplish these effects without using the beta-adrenergic receptor site.
 
I had one of these which I posted about, mine was not as bad as yours. I did not think they required epi, but they got benadryl and solumedrol. Dr. gave .3mg Epi IM when we got there. 9y/o male.
 
sdadam said:
Almost but not quite.

Glucagon does increase the second messenger cAMP through stimulatory g-protein action on adenylate cyclase.

However it is not by way of beta 2 agonism as stated.

It is through activation of specific glucagon receptors which, although have similar intracellular effects to adrenergic receptors, cause different systemic responses mainly based on there varied expression.

This means that even in a hypothetical complete, irreversible and non-selective beta blockade glucagon is capable of causing an adrenergic type response. Describing it's effects as being "by way of beta 2 agonis(m)" is incorrect and could confuse people.
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HE BEAT ME TO IT!!:sad::unsure:

Thats ok, he said it better than i could have lol.
 
This website should help some people. I found it useful! I never thought about it in an asthmatic. Ive had 2 pts I've had to drop and tube and despite me throwing the book at both of them, ventilations with bvm & ett were tough. Neither one ever opened up during transport. I wonder if Glucagon would have made a difference. After reading this, I really wish my service carried more than the 1mg we do.
 
Holy necromancy batman.

Sent from LuLu using Tapatalk
 
NREMTB12 said:
cAMP is this adenosine monophosphate??
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glycogen_regulation_cAMP.jpg


Technically it's cyclic adenosine monophoshphate, with a diester linkage (middle image). Read more here:

http://en.wikipedia.org/wiki/Cyclic_adenosine_monophosphate
 
Only non-cardioselective beta-blockers?
 
Are most people's protocols still describing SQ epinephrine?

The standard of care, reflected in national guidelines, call for 0.01 mg/kg (max 0.5mg) intramuscular. The research showing that the IM route is preferable is pretty compelling. Google around for the "Second symposium on the definition and management of anaphylaxis:"

Around my neck of the woods, the ALS protocols dictate the IM route - got changed a number of years ago.
 
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KellyBracket said:
Are most people's protocols still describing SQ epinephrine?

The standard of care, reflected in national guidelines, call for 0.01 mg/kg (max 0.5mg) intramuscular. The research showing that the IM route is preferable is pretty compelling. Google around for the "Second symposium on the definition and management of anaphylaxis:"

Around my neck of the woods, the ALS protocols dictate the IM route - got changed a number of years ago.
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Ours changed to IM a couple of days ago.
 
KellyBracket said:
Are most people's protocols still describing SQ epinephrine?

The standard of care, reflected in national guidelines, call for 0.01 mg/kg (max 0.5mg) intramuscular. The research showing that the IM route is preferable is pretty compelling. Google around for the "Second symposium on the definition and management of anaphylaxis:"

Around my neck of the woods, the ALS protocols dictate the IM route - got changed a number of years ago.
Click to expand...

Still SQ :wacko:
 
18G said:
Ours has been IM for years now.
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Likewise, I can't say I have ever seen it given subcutaneously. It sometimes get charted that way because medical professionals are often rather dense...
 
In my county we can only give epinephrine subcutaneously or IV. Deep IM is not authorized yet. I do not know if it is going to be authorized at all.
 
We gave it SQ.

I can see where IM has some benefits, just don't get the bolus too near a nerve. I've seen sloughs where it was intra and not sub dermal, or into fat.

Is Susphrine still used?
 
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