Victoria Cardona
Head of the Allergology Department of the Vall d'Hebron University Hospital (Barcelona) and President of the Anaphylaxis Committee of the Spanish Society of Allergology and Clinical Immunology
Anaphylaxis is basically a severe and rapid allergic reaction that usually manifests with skin symptoms and affects other systems such as the respiratory, cardiovascular or digestive systems. The risk, although rare, is a fatal outcome. Rapid and effective treatment is therefore indicated. Currently, adrenaline administered intramuscularly in the lateral aspect of the thigh is considered the treatment of choice.
However, we know that many patients are reluctant to use adrenaline auto-injectors for various reasons: fear of injections, fear of adverse effects, or even because they do not want to have to go to an emergency centre afterwards, which is the usual recommendation.
The emergence of new devices that deliver the adrenaline dose by alternative routes such as intranasal nebulisation may help to address these fears. The published studies, although conducted mainly in healthy volunteers and not in patients during a reaction, seem to indicate good absorption of the drug and a good pharmacological effect. This could therefore be a paradigm shift in self-treatment by patients during anaphylactic reactions.