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EPINEPHrine (Anaphylaxis)
EPINEPHrine is a life-saving medication used to treat anaphylaxis, a severe allergic reaction that can occur within minutes of exposure to an allergen. Epinephrine works by stimulating alpha and beta-adrenergic receptors, leading to vasoconstriction, bronchodilation, and an increase in heart rate. This quickly reverses the symptoms of anaphylaxis, including swelling, difficulty breathing, and low blood pressure.
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Frequently Asked Questions
How quickly does epinephrine work?
Epinephrine typically begins to work within minutes after injection, providing rapid relief from the life-threatening symptoms of anaphylaxis.
Can I inject epinephrine myself?
Yes, epinephrine auto-injectors are designed for self-administration. If you are at risk of anaphylaxis, you should be trained in how to use your auto-injector and act quickly at the first sign of an allergic reaction.
How long does the effect of epinephrine last?
The effects of epinephrine usually last 10 to 20 minutes, but multiple doses may be needed if symptoms persist. Always seek emergency medical attention after using epinephrine.
What should I do if I accidentally inject epinephrine into my hand or finger?
Accidental injection into small extremities like the hand or finger can cause restricted blood flow and tissue damage. Seek immediate medical attention if this happens.
Is epinephrine safe for children?
Yes, epinephrine is safe for children at the appropriate dose. Pediatric auto-injectors (0.15 mg) are available for children weighing between 15 kg and 30 kg (33-66 lbs). Always follow your healthcare provider’s guidance.
Comprehensive Drug Guide
How Does EPINEPHrine (Anaphylaxis) Work?
Epinephrine works by stimulating alpha-1 receptors, which cause vasoconstriction to raise blood pressure and reduce swelling, and beta-1 and beta-2 receptors, which increase heart rate and cause bronchodilation (opening the airways). This helps to counteract the life-threatening effects of anaphylaxis, including difficulty breathing, swelling, and cardiovascular collapse.
Common Dosages
- For anaphylaxis: Inject 0.3 mg (for adults) or 0.15 mg (for children) intramuscularly into the outer thigh. If symptoms persist or return, a repeat dose can be given every 5-15 minutes, up to three doses. Seek immediate medical attention after using epinephrine.
Typical Dosing
FDA Approved Indications
- Anaphylaxis (severe allergic reactions)
- Emergency treatment of allergic reactions triggered by food, insect stings, drugs, or other allergens
Who Shouldn't Take EPINEPHrine (Anaphylaxis)?
Epinephrine should not be withheld in life-threatening situations like anaphylaxis. There are no absolute contraindications for epinephrine use in emergency treatment. However, caution is advised in individuals with:
- Uncontrolled hypertension
- Heart disease
In life-threatening allergic reactions, the benefit of using epinephrine outweighs any potential risks.
Advice From The Pharmacist
- Carry an epinephrine auto-injector with you at all times if you have a history of severe allergic reactions or are at risk for anaphylaxis.
- Use epinephrine at the first sign of anaphylaxis: symptoms may include difficulty breathing, swelling of the face or throat, hives, or a rapid drop in blood pressure.
- After using the auto-injector, seek emergency medical help immediately, even if symptoms improve, as further treatment may be required.
- Ensure you know how to properly use the auto-injector and educate family members, caregivers, or colleagues on its use as well.
- Store auto-injectors at room temperature and protect them from heat and light. Avoid refrigerating or freezing.
Side Effects of EPINEPHrine (Anaphylaxis)
Common Side Effects
- Rapid or irregular heartbeat (palpitations)
- Tremors
- Nervousness or anxiety
- Sweating
- Headache
- Dizziness
Uncommon/Severe Side Effects
- Severe hypertension (high blood pressure)
- Arrhythmias (irregular heartbeats)
- Myocardial infarction (heart attack)
- Cerebrovascular events (stroke)
Risks and Warnings of EPINEPHrine (Anaphylaxis)
- Cardiovascular Risks: Epinephrine can cause significant increases in heart rate and blood pressure, potentially leading to arrhythmias, heart attack, or stroke, particularly in patients with pre-existing cardiovascular conditions.
- Tissue Damage: Avoid injecting epinephrine into smaller areas of the body, such as the hands, feet, or buttocks, as it can cause severe vasoconstriction, leading to tissue damage or necrosis.
- Central Nervous System Effects: Epinephrine may cause anxiety, restlessness, or tremors due to its stimulating effects on the nervous system.
Interactions with EPINEPHrine (Anaphylaxis)
Common Drug Interactions
- Beta-blockers: Beta-blockers can reduce the effectiveness of epinephrine, particularly in treating anaphylaxis, and may worsen bronchospasm.
- Monoamine oxidase inhibitors (MAOIs): These medications may enhance and prolong the effects of epinephrine, leading to severe hypertension.
- Tricyclic antidepressants (TCAs): These can increase the cardiovascular effects of epinephrine, leading to an increased risk of hypertension and arrhythmias.
Alternatives to EPINEPHrine (Anaphylaxis)
- Antihistamines (e.g., diphenhydramine): Used as an adjunct treatment for allergic reactions, but they should not be used alone for anaphylaxis. Epinephrine is the first-line treatment.
- Albuterol: Can be used as a bronchodilator for asthma-related symptoms during anaphylaxis but should not replace epinephrine.
- Corticosteroids (e.g., prednisone): May be used to reduce inflammation after anaphylaxis but work too slowly to replace epinephrine for immediate treatment.
