CASE FILE - 1

A 12-year old girl presents to your office with a sore throat and fever. You diagnose her with pharyngitis caused by group A beta hemolytic streptococcus. She is given an IM injection of penicillin. Approximately 5 minutes later , she is found to be in respiratory distress and audibly wheezing. Her skin is mottled and cool. She is tachycardiac, and her BP has fallen to 70/20 mm hg. You immediately diagnose her as having an anphylactic reaction to the penicillin and give an IM injection of epinephrine.

Questions

1. What effect will epinephrine have on this patient’s vascular system?

2. Which adrenoceptor primarily mediates the vascular response?

3. What effect will epinephrine have on her respiratory system?

4. Which adrenoceptor primarily mediates the respiratory system response?

Summary A 12-year-old girl with “strep sore

throat” is given an injection of penicillin and developes an acute anaphylactic reaction

Effect of epinephrine on vascular system

Vasoconstriction

Adrenoceptor which primarily mediates the vascular response

Alpha -1

Effect of epinephrine on the pulmonary system

Bronchial muscle relaxation

Adrenoceptor which primarily mediates the pulmonary response

Beta-2