Could primatene theoretically be used for anaphylaxis?

Question

I'm a curious little EMT student.

First, I'd like to put the intent of this knowledge into context: In an emergency situation, not even a day to day emergency, I'm talkin' "post-apocalyptic, volcanos exploding, government's dead, zombies everywhere, and of all the people who got stung a bee that day, it had to be you" sort of anaphylactic emergency... Basically, a story plot!

The common over the counter inhaler, primatene, is just epinephrine (adrenaline)... which is exactly what's in epi-pens. With this in mind, logic would tell me that primatene (which, again, is just epinephrine) could be used in the absence of an epi-pen during anaphylaxis (assuming of course user was physically capable of inhaling it).

Is that true? If I wrote a story where someone treated anaphylaxis with primatene would that be perfectly plausible or would I be way outta' line? If not... Then why not? What's the difference between absorption administering adrenaline by inhaler and by Intramuscular injection...?

If so... Could an epipen thereby be used for an asthma attack (I'm guessing no =P).

Anonymous · Accepted Answer

Primatene would be unlikely to work for a true anaphylactic reaction for two reasons:

1.  The dose of epinephrine in a Primatene inhaler would not be sufficient to do the job - maybe if you inhaled the whole thing, but still . . . .

2.  The inflammitory mediators involved in anaphylaxis are systemic, not just confined to the pulmonary system.  Therefore, trying to get a dose strictly by the pulmonary vascular route (inhaled) would probably not work well.  You need to get the epi into the systemic circulation immediately.  Hence, the use of IM or even IV route for cases of severe anaphylaxis.

That being said, if I was in some theoretical universe with zombies trolling about and volcanos erupting, had no epi or other medical equipment about, and had only a Primatene inhaler available, I'd try it!  What the heck . . . . we're all gonna die anyway, right?   ;-)

And yes, Epi-pens are available and occasionally prescribed for severe asthmatics with a history of severe attacks and intubations.  They are for emergency (zombie world) use only and are meant to perhaps buy that person a little time to get their butt to the ER.  

Hope this helps.  Good luck in your EMT career! :-)

gaisford · Answer

I might say 'keep in case you wish', 'Go in case you wish'. As lengthy as my contacts wrote me as soon as a month or so. Just to mention hi there. My music of in these days used to be Darling Nikki. My day used to be unhealthy, however intriguing. I found out plenty in these days!

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Could primatene theoretically be used for anaphylaxis?

2 Answers