In anaphylaxis, which medication should be administered first?

In cases of anaphylaxis, epinephrine is the first-line treatment and should be administered immediately. This is because epinephrine acts quickly to mitigate the severe physiological symptoms associated with anaphylaxis, such as bronchospasm, vasodilation, and increased vascular permeability. By stimulating alpha and beta adrenergic receptors, epinephrine helps to reverse airway swelling and reduce hypotension, thereby stabilizing the patient's condition.

Aspirin is not appropriate as it does not address the life-threatening aspects of anaphylaxis. Diphenhydramine, while an antihistamine that can help with itching and hives, does not provide the rapid relief necessary for the severe systemic effects of anaphylaxis. Corticosteroids can help with the late-phase response of anaphylaxis but take hours to reach their effect and are not suitable as an immediate intervention.

Thus, the administration of epinephrine should be prioritized in anaphylactic emergencies to ensure a prompt and effective response.