What condition is an indication for epinephrine 1:1000?

• A. Hypoglycemia
• B. Anaphylaxis
• C. Acute gout
• D. Hypertension

Answer: (B)

Epinephrine 1:1000 given intramuscularly is the first-line treatment for anaphylaxis because it rapidly reverses the life-threatening features: airway edema and bronchospasm, along with improving blood pressure by vasoconstriction. The 1:1000 concentration is the standard IM formulation used in anaphylaxis.

In this setting, the drug works on multiple receptors: alpha-1 causes vasoconstriction to reduce edema and raise blood pressure; beta-2 causes bronchodilation to relieve bronchospasm; beta-1 increases heart rate and contractility to support circulation. This combination makes it uniquely effective for systemic allergic reactions.

Other conditions listed are not indications for epinephrine 1:1000 in this context. Hypoglycemia is managed with glucose or glucagon. Acute gout is treated with anti-inflammatories or colchicine. Hypertension is treated with antihypertensives. While epinephrine can affect glucose and blood pressure, it is not the standard immediate treatment for these conditions.

Dosing for adults is typically 0.3–0.5 mg of 1:1000 epinephrine IM, with repetition every 5–15 minutes if symptoms persist; for children, 0.01 mg/kg (up to 0.3 mg) IM, repeating as needed. Administration is usually via an intramuscular injection in the thigh (or an auto-injector).