Q: With respiratory distress in anaphylaxis, if no epinephrine is available could an albuterol inhaler be used until the benedryl takes effect?
If the symptoms are isolated to the lower airways as manifested by wheezes, an inhaled Beta agonist like albuterol will probably help with the symptoms. But remember that unlike asthma, anaphylaxis is a systemic, not a local, problem. In anaphylaxis chemical mediators are released in the circulation and then migrate to sites around the body. Albuterol works locally and will have no effect on the generation of these mediators. If the manifestations are shock or upper airway obstruction (the two most lethal manifestations of anaphylaxis), the albuterol will not be useful.