A 25-year-old patient presents to the emergency department with widespread urticaria, throat tightness, and difficulty breathing 10 minutes after being stung by a bee. The patient's blood pressure is 90/60 mmHg. What is the most appropriate initial treatment?
Intramuscular epinephrine is the first-line treatment for anaphylaxis as it quickly works to reverse the pathophysiologic processes of anaphylaxis, which can include airway edema, hypotension, and shock. Antihistamines, while useful for symptomatic relief of urticaria and pruritus, do not address the hemodynamic and respiratory issues as effectively. Corticosteroids have a delayed onset and are not the primary treatment in the acute management of anaphylaxis. Normal saline is supportive treatment for hypotension but does not counteract the underlying anaphylactic reaction.
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