For persistent severe anaphylaxis using Epinephrine 0.1 mg/mL, what is the initial IV/IO dose?

• A. 0.1 mg slow IVP/IO
• B. 0.3 mg slow IVP/IO
• C. 0.5 mg slow IVP/IO
• D. 1 mg slow IVP/IO

Answer: (A)

In persistent severe anaphylaxis treated with IV/IO epinephrine, you use a small, dilute bolus to rapidly support perfusion while limiting side effects. With a solution of epinephrine 0.1 mg/mL (which is 1:10,000), a dose of 0.1 mg corresponds to 1 mL. So the initial IV/IO dose should be 0.1 mg (1 mL) given slowly. This small bolus provides the needed adrenergic作用 without overshooting, and can be repeated or titrated if symptoms persist.

Higher numbers (0.3 mg, 0.5 mg, or 1 mg) would deliver much larger IV doses that pose greater risk of tachycardia, hypertension, and arrhythmias in this setting, and are not appropriate as the initial IV/IO bolus for anaphylaxis with that concentration.