A patient develops anaphylaxis during a dental procedure. What is the drug of choice and route of administration?

Epinephrine is the drug of choice for anaphylaxis. The recommended formulation is 1:1,000 (1 mg/mL) epinephrine administered intramuscularly (IM) into the mid-outer thigh (vastus lateralis). The standard adult dose is 0.3 to 0.5 mL (0.3 to 0.5 mg). The 1:10,000 concentration is used intravenously in cardiac arrest (not for anaphylaxis in the dental office). Epinephrine reverses bronchospasm (beta-2 effect), vasoconstriction (alpha-1 effect reduces hypotension), and reduces mucosal edema. Diphenhydramine and corticosteroids are adjunct treatments but are NOT first-line and should never replace epinephrine. Call 911 immediately after administering epinephrine.