Which of the following are indications for epinephrine in adults?

• A. Oral/Lingual/Angioedema; Difficulty breathing
• B. Difficulty breathing; Stridor
• C. Hypotension following exposure; Stridor
• D. Oral/Lingual/Angioedema; Difficulty breathing; Stridor; Hypotension following exposure

Answer: (D)

Epinephrine is the first-line treatment for adults with suspected anaphylaxis because it quickly counteracts the processes driving airway swelling, bronchoconstriction, and shock. When a patient has been exposed to a trigger and shows signs of airway involvement or low blood pressure, giving epinephrine addresses multiple life-threatening issues at once: it reduces mucosal edema in the airway, relaxes bronchial smooth muscle to improve breathing, and causes vasoconstriction to raise blood pressure and lessen edema. Therefore, the indications include oral, lingual, or facial angioedema; difficulty breathing; stridor; and hypotension after exposure. This combination reflects the full range of potential severe reactions that require prompt epinephrine. If a option misses any one of these signs, it’s incomplete because there could still be airway compromise or shock and the patient would benefit from epinephrine.