What is the appropriate dosage for a pediatric patient with severe wheezing and respiratory distress unimproved after albuterol?

The appropriate dosage for a pediatric patient experiencing severe wheezing and respiratory distress that has not improved after administration of albuterol is to use Epi-Pen Jr. (0.15mg) administered intramuscularly (IM) into the lateral thigh, with the option to repeat every 5 minutes as needed. This option is effective because epinephrine acts as a bronchodilator, providing rapid relief from bronchospasm. It stimulates beta-adrenergic receptors, leading to the relaxation of bronchial smooth muscle and helps alleviate respiratory distress associated with severe wheezing.

In this scenario, after the initial albuterol treatment, which is a common first-line therapy for wheezing in children, the lack of improvement indicates that a stronger intervention, like epinephrine, may be necessary. The quick action of IM epinephrine makes it suitable for acute exacerbations, and its repeat dosing can be critical in managing severe cases until the patient stabilizes.

The other options, such as the full-dose Epi-Pen for adults or repeated albuterol nebulizations, may not provide the timely intervention required in this acute scenario. Moreover, suctioning the airway would not be appropriate as a primary treatment for wheezing and respiratory distress without evidence of airway obstruction