Injection, 1 mg (as hydrogen tartrate) in 1-ml ampoule

General information

Epinephrine is a sympathomimetic agent that activates both α- and β-adrenoreceptors. It is secreted together with norepinephrine by the adrenal medulla in response to stress. Activation of the α-adrenoreceptors increases the blood pressure and induces peripheral vasoconstriction, while activation of the β-adrenoreceptors induces bronchodilatation and increases cardiac inotropic activity.

Clinical information

Uses

Treatment of anaphylactic shock.

Dosage and administration

Adults and children: all patients requiring this form of therapy should receive an immediate i.m. injection of 0.5-1.0 ml of epinephrine, 1:1000 solution. Cardiac arrhythmias and hypertension are likely to occur if more than 2 ml is administered within any 5-minute period. When the circulatory response is transient, use of a plasma expander should be considered.

Precautions

There are no absolute contraindications to the use of epinephrine in this potentially life-saving situation. However, it should be used with particular caution in patients with hypertension, atherosclerotic heart disease, cerebral vascular insufficiency, heart block, thyrotoxicosis or diabetes, who are vulnerable to severe and unpredictable changes in blood pressure during treatment.

Drug interactions

The risk of cardiac dysrhythmias is increased when epinephrine is administered to patients receiving a digitalis glycoside, quinidine, a tricyclic antidepressant or a thyroid hormone.

Overdosage

Acute hypertensive crises and life-threatening dysrhythmias may be controlled by propranolol or other β-adrenoreceptor blocking agents.

Storage

Ampoules should be stored protected from light.