In anaphylaxis due to peg-Asparaginase, what is the preferred route for epinephrine administration?

• A. PO
• B. Sub-Q
• C. IV
• D. IM

Answer: (D)

Rapid treatment of anaphylaxis relies on immediate epinephrine to counteract airway swelling, bronchospasm, and vascular leak. The intramuscular route is preferred because it delivers epinephrine quickly and reliably, usually into the mid-outer thigh, with a lower risk of complications than other routes. Subcutaneous administration can be slower and less predictable, especially when perfusion is poor in shock. Oral dosing is ineffective in this emergency, and intravenous administration is reserved for severe cases in a monitored setting due to the higher risk of overdose and cardiac complications. So, intramuscular epinephrine is the best choice.