Epinephrine

GENERIC NAME:Epinephrine

BRAND NAME: Adrenaline

Drug classes

Sympathomimetic drug
Alpha-adrenergic agonist
Beta1- and beta2-adrenergic agonist
Cardiac stimulant
Vasopressor
Bronchodilator
Antasthmatic
Nasal decongestant
Mydriatic
Antiglaucoma drug

Actions of Adrenaline

Increased metabolism
Cardiac stimulant & Increased heart rate
Increased blood pressure
Increased blood flow to muscles
Constriction of blood vessels vasoconstriction

Indications

Injection: Relief from respiratory distress of bronchial asthma, chronic bronchitis, emphysema, other COPDs
Aerosols and solutions for nebulization: Temporary relief from acute attacks of bronchial asthma, COPD
Topical nasal solution: Temporary relief from nasal and nasopharyngeal mucosal congestion due to a cold, sinusitis, hay fever, or other upper respiratory allergies; adjunctive therapy in middle ear infections by decreasing congestion around eustachian ostia
0.1% ophthalmic solution: Conjunctivitis, during eye surgery to control bleeding, to produce mydriasis

Contraindications

Adrenaline may be administered in life-threatening anaphylactic reactions, even when the following relative contraindications are present
Coronary artery disease
Uncontrolled hypertension
Serious ventricular arrhythmias
Second stage of labour

Precautions

Use with caution in elderly and patients that have:
Hyperthyroidism
Diabetes
Hypertension
Cardiovascular disease angina, arrhythmias
Stroke
Prostatic enlargement

Available forms

Solution for inhalation—1:100, 1:1,000, 1.125%, 1%; aerosol—0.35 mg, 0.5%, 0.22 mg; injection—1, 5 mg/mL; solution for injection—1:1,000, 1:2,000, 1:10,000

Nursing considerations

WARNING: Use extreme caution when calculating and preparing doses; epinephrine is a very potent drug; small errors in dosage can cause serious adverse effects. Double-check pediatric dosage
Use minimal doses for minimal periods of time; "epinephrine-fastness" (a form of drug tolerance) can occur with prolonged use
Protect drug solutions from light, extreme heat, and freezing; do not use pink or brown solutions. Drug solutions should be clear and colorless does not apply to suspension for injection
Shake the suspension for injection well before withdrawing the dose
Keep a rapidly acting alpha-adrenergic blocker (phentolamine) or a vasodilator (a nitrate) readily available in case of excessive hypertensive reaction
WARNING: Have an alpha-adrenergic blocker or facilities for intermittent positive pressure breathing readily available in case pulmonary edema occurs
WARNING: Keep a beta-adrenergic blocker (propranolol; a cardioselective beta-blocker, such as atenolol, should be used in patients with respiratory distress) readily available in case cardiac arrhythmias occur