Bob Allen <[log in to unmask]> asked about the effectiveness of Primatene Mist against anaphylaxis.

It would be better than nothing but should not be relied upon for any serious threat.

When optimally used (something that even most asthmatics do wrong), the Primatene Mist inhaler delivers 0.22 mg of epinephrine.  In the midst of a stinging event, most of us are likely to get a much lower effective dose.  For comparison, the standard dose of an Epi-pen is 0.30 mg, all of which enters your blood stream quickly.  (The dosage for the Epi-pen Junior - for kids under 66 lbs - is 0.15mg.)

Second, the respiratory delivery method works best if your primary symptom is shortness of breath.  The epinephrine immediately acts as a vasoconstrictor on the alveoli in the lungs.  It's uptake and effectiveness for other anaphylactic symptoms is degraded.

Finally, as you said in your post, you have to be able to breathe to make it work at all.  You also have to be conscious.  By the time you can get away from the bees, get your veil off and get to the inhaler, those are questionable assumptions.  A co-worker can administer an Epi-pen to you right through the suit and even after you pass out.

I'd use the inhaler if I had no other choice.  I prefer to keep an Epi-pen at hand.

No matter what you do, seek professional medical help immediately afterward.  If it was serious enough for you to medicate yourself, it is serious enough to require some follow-up.


Mike Rossander

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