ANS Adrenergic Drug Case Study
Your resident went out to eat with his family. When he returned, he reported that they went to an
Indian restaurant where he had a meal made with curry. Despite asking for a meal with no nuts,
he is sure that he could taste some in the curry. You know that he has an allergy to nuts. Your
resident reports that he feels a little bit tight-chested. On examination, the only abnormal finding
you note is a slightly increased respiratory rate.
Clinical assessment: his breathing is slightly increased with a respiratory rate of 20 breaths per
minute; pulse is 88 beats per minute; BP 112/62 mmHg; he is alert, but anxious.
What other assessments would you perform?
Swollen lips or tongue?
Rash (hives)?
Listen to lungs. Is there wheezing?
What else will you do at this point?
Delegate someone to call the restaurant
Ask if he already had an injection of epinephrine?
Over the next 10 minutes, he becomes very short of breath, has a widespread wheeze,
develops an urticarial rash (hives), and feels light-headed.
Clinical assessment: Complains of tightness in his throat.
What would you expect to see with his respiratory rate, his pulse, and his blood pressure? How
about his anxiety level?
Increase respiratory rate
Elevated pulse
High blood pressure
Increased anxiety level
What other assessments would you perform?
Get new vitals
What else would you do at this point?
Call 911
If he has an epi pen, give it
If we didn’t have epinephrine, make sure it’s ordered in case of future allergic reaction
Get AED in case he goes into cardiac arrest
Contact his family
