What is the first-line treatment for anaphylactic shock?

The first-line treatment for anaphylactic shock is epinephrine. Anaphylaxis is a severe, life-threatening allergic reaction that occurs rapidly after exposure to an allergen. The primary pathophysiological mechanisms involved include widespread vasodilation, increased vascular permeability, and bronchoconstriction, which can lead to hypotension, swelling, and respiratory distress.

Epinephrine, an adrenergic agonist, serves multiple crucial roles in treating anaphylaxis. It works by causing vasoconstriction, which increases systemic vascular resistance and blood pressure. Additionally, it relaxes the bronchial smooth muscles, counteracting bronchospasm, thereby improving breathing. It also helps reduce edema and hives by acting on the vascular permeability of blood vessels. Administering epinephrine promptly is essential to reversing the life-threatening effects of anaphylaxis.

While other treatments like fluid resuscitation and intravenous steroids may be adjunctive in the management of anaphylaxis, they do not address the immediate threats to life as effectively as epinephrine. Fluid resuscitation may help manage hypotension but does not treat the underlying cause, and steroids have a delayed onset and therefore are not appropriate as a first-line agent in acute situations.