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EPINEPHrine
Epinephrine is a lifesaving medication used in emergencies to treat serious allergic reactions to insect bites/stings, foods, medication, and other triggers. It works by opening airways, narrowing blood vessels, and helping the heart to function during extreme allergic reactions. Some common side effects following its use can include temporary headaches, irregular heartbeat, increased blood pressure, and anxiety. It is generally prescribed as a rescue medication in cases of severe allergic reactions, known as anaphylaxis.
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Frequently Asked Questions
Can I administer Epinephrine myself in case of an allergy?
Yes, but you should receive adequate training first. Epinephrine autoinjectors (like EpiPen) are designed to be used by nonmedical individuals, such as allergic individuals themselves or their caregivers.
I accidentally left my Epinephrine autoinjector in the car and it got hot, can I still use it?
Epinephrine is sensitive to light and extreme heat. It is best to store it at room temperature (between 68 to 77 degrees F). If an autoinjector has been exposed to extreme conditions, it might be less effective.
I experienced chest pain after using Epinephrine, is that normal?
While it is one of the known side effects of Epinephrine, you should seek emergency medical attention if you have chest pain. It can be an indication of a more serious side effect such as a heart attack.
I have high blood pressure, can I use Epinephrine in case of an allergic emergency?
Yes, if you're having an anaphylactic reaction, the benefits of using Epinephrine greatly outweigh the risks. However, do consult your healthcare provider for the most suitable treatment.
My child had a severe allergic reaction, can he use the same dose of Epinephrine as adults?
Epinephrine dosing is weightbased. Children under 30 kg usually receive smaller doses. However, in an emergency, if only an adultdose auto injector is available, it can be used.
Comprehensive Drug Guide
How Does EPINEPHrine Work?
Epinephrine, a potent ?, and ? adrenergic agonist, is effective in reversing the manifestations of anaphylaxis. It alleviates wheezing and shortness of breath by causing bronchodilation, it combats urticaria and angioedema by leading to vasoconstriction, and it aids in preventing and arresting cardiovascular collapse by stimulating the heart.
What is EPINEPHrine Used For?
FDA indications: Epinephrine is used for the emergency treatment of severe allergic reactions (Type 1) including anaphylaxis to insect bites and stings, allergen immunotherapy, foods, drugs, diagnostic testing substances, and other allergens, as well as exerciseinduced anaphylaxis.
Offlabel uses: Epinephrine may also be used offlabel in a medical setting to restart the heart during cardiac arrest, manage bleeding, assist in emergency childbirth, or for severe asthma attacks.
Common Dosages
Intramuscular/Subcutaneous: 0.3mg
Topical: 2%
Inhalation: 0.5 mL of a 1:1000 solution in 2.5 mL normal saline via nebulizer, or 12 puffs with MDI every 46 hours if needed.
Typical Dosing
FDA Approved Indications
- For the emergency treatment of severe allergic reactions, the typical adult dose is 0.3 mg of epinephrine administered intramuscularly or subcutaneously into the anterolateral aspect of the thigh, as soon as anaphylaxis is recognized.
- For repeat administration, epinephrine injections may be administered at approximately 515 minute intervals as necessary, under medical supervision.
Off-Label Uses
- For the treatment of other conditions such as cardiac arrest, dosing may vary and is typically provided under the guidance of a medical professional.
Who Shouldn't Take EPINEPHrine?
- Those who are hypersensitive to Epinephrine or any of the other ingredients in the formulation.
- Although Epinephrine may be lifesaving in humans with severe anaphylaxis, it should be used with caution in individuals who have heart disease.
- Epinephrine should be used with caution in patients with hyperthyroidism, diabetes, hypertension, and arrhythmias, in elderly individuals and pregnant women.
- Patients undergoing labor, as Epinephrine may delay the second stage of labor.
Advice From The Pharmacist
- Be sure to receive proper training in how to use Epinephrine in an emergency.
- Go to a hospital or call an ambulance after its use, even if the symptoms appear to have improved, to ensure adequate medical assistance.
- Store it at room temperature, and always keep it within easy access.
- Swap the Injector before the end of the expiration period.
- Don?t accidentally inject Epinephrine into your hands or feet, it could lead to circulatory problems.
- Remember, while Epinephrine will help treat the symptoms of an allergic reaction, it's not a replacement for seeking immediate medical help.
- Understand what triggers your allergies and aim to avoid those allergens.
Side Effects of EPINEPHrine
Common Side Effects
- Feelings of anxiety or nervousness
- Headache
- Irregular heartbeat
- Increased respiratory rate
- Paleness
- Nausea or vomiting
Uncommon/Severe Side Effects
- Uncommon side effects:
- Sweating
- Dizziness
- Tremor
- Chest pain
- Weakness
- Rare side effects:
- Respiratory difficulty
- Hyperglycemia
- Hypertension
- Arrhythmia
- Severe side effects:
- Heart attack or stroke due to extreme increases in heart rate or blood pressure
- Complications if accidentally injected into the hands or feet, leading to loss of blood flow in these regions.
Risks and Warnings of EPINEPHrine
- Epinephrine may cause serious side effects including increased heart rate, irregular heart rhythm, sweating, nausea and vomiting, difficulty breathing, paleness, dizziness, weakness, or shakiness
- Rapid heartbeats may lead to cardiac arrest or stroke, particularly in elderly patients or those with heart problems.
- It may also cause respiratory difficulty or hyperventilation, and caution should be observed in asthmatic patients.
- In patients with hypertension, Epinephrine may lead to a sharp increase in blood pressure.
- Epinephrine should not be injected into your hands, feet, buttocks, or directly into a vein because it may cause tissue necrosis.
- In extremely rare cases, it can lead to lactic acidosis, a serious metabolic disorder.
- Use with extreme caution in patients with prostatic hypertrophy and bladder neck obstruction due to the risk of acute urinary retention.
Interactions with EPINEPHrine
Common Drug Interactions
- BetaBlockers: may antagonize the effects of epinephrine
- Antidepressants (like SSRIs, SNRIs, and MAOIs)
- Certain Antihistamines
- Diuretics
Alternatives to EPINEPHrine
- Important note: There isn?t an alternative to Epinephrine for severe allergic reactions. It?s considered the firstline defense against anaphylaxis and can be lifesaving in these situations.