Date Published

June 20, 2022

Updated For

ALS PCS Version ALS PCS Version 5.2


Can you rationalize the administration of Epi prior to salbutamol in severe asthma exacerbation Pt? I know they both have bronchodilatory properties, just curious as to the additional benefits


From a pathophysiologic perspective: Epinephrine can provide beta-agonist effects (similar to salbutamol) as well as alpha-adrenergic effects that can rapidly reduce airway edema.  From a practical perspective, it can be administered concurrently without hampering airway and ventilatory management in patients with severe respiratory distress. Please note that the evidence for IM epinephrine in severe asthma exacerbation is very sparse. The majority of asthma guidelines do not utilize IM epinephrine, even in the treatment of severe asthma.



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