Epinephrine
Uses of Epinephrine
Epinephrine is primarily used for the management of anaphylaxis and cardiac arrest. It belongs to a group of compounds known as catecholamines.
Secondary uses of Epinephrine include controlling superficial bleeding, often during dental procedures.
Side effects of Epinephrine
Anxiety
Tremors
Rapid heartbeat (Tachycardia)
Sweating
Nausea and vomiting
How Epinephrine works
Epinephrine (or adrenaline) is a naturally occurring hormone and neurotransmitter that acts on specific receptors found in many parts of the body including the heart, blood vessels and lungs. When Epinephrine binds to these receptors, it triggers a series of effects that are part of the body's 'fight or flight' response. This helps counteract severe allergic reactions, restart the heart in cases of cardiac arrest, and control superficial bleeding.
Specifically, in case of an allergic reaction, Epinephrine eases breathing by expanding air passages, boosts blood flow by constricting blood vessels, and alleviates skin symptoms such as hives and swelling.
For cardiac arrest management during cardiopulmonary resuscitation (CPR), Epinephrine increases cardiac output which helps to restore spontaneous circulation.
When applied topically to control superficial bleeding, it narrows blood vessels at the site, reducing blood flow and aiding clotting.
Certified content
Written By
Doctor of Medicine
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Epinephrine is primarily available as an injectable medicine, which ensures rapid action in emergency situations. The routes of administration for Epinephrine include intramuscular (into the muscle), subcutaneous (under the skin), and intravenous (into the vein) injections.
For treating superficial bleeding, Epinephrine can also be applied topically in a very dilute solution.
Age and Dose Restrictions
Epinephrine is suitable for use in both adults and children.
Contraindications
This medicine is contraindicated in patients with a known hypersensitivity to Epinephrine.
It is also contraindicated in patients with certain cardiovascular diseases, including coronary insufficiency and angina pectoris.
Other Medications to Avoid
This medicine may interact with sympathomimetic agents (such as pseudoephedrine and phenylephrine), beta-blockers (including atenolol and propranolol), tricyclic antidepressants (like amitriptyline and clomipramine), and monoamine oxidase inhibitors (such as phenelzine and tranylcypromine).
Overdose and Missed Dose
An overdose of Epinephrine can lead to severe hypertension, cerebral haemorrhage, pulmonary oedema, and cardiac arrhythmias. Immediate medical attention is crucial to manage these symptoms effectively.
If you miss a scheduled dose of Epinephrine during regular treatments for conditions like asthma, ask your doctor to administer it as soon as you remember. However, if it is close to the time for your next dose, skip the missed dose to avoid doubling up.
Management of Side Effects
Most side effects are temporary and generally harmless and resolve when discontinuing this medicine. However, if you experience any severe side effects or worsening of any of the symptoms, please consult your doctor.
If experiencing palpitations or trembling, try relaxing techniques and ensure a calm environment.
For sweating or nausea, remain hydrated by drinking water regularly.
Use in Driving and Operating Machinery
The use of Epinephrine may impact your ability to drive or operate machinery, especially if you experience side effects like dizziness or shaking.
Use in Pregnancy and Lactation
Consult your doctor before using Epinephrine if you are pregnant or breastfeeding.
Caution in Other Conditions
Patients with pre-existing conditions such as diabetes, hyperthyroidism, or severe hypertension should exercise caution when using Epinephrine.
Those with a history of cerebrovascular diseases should also be cautious due to the potential for inducing severe hypertension.
Special Dietary and Lifestyle Recommendations
Manage stress through relaxation techniques like yoga or meditation to help mitigate any potential increase in blood pressure due to stress, which Epinephrine could exacerbate.
Maintain a low-sodium diet to manage hypertension – high blood pressure can be a side effect of Epinephrine, especially if overdosed.
Regular cardiovascular monitoring is recommended for those who routinely use Epinephrine for chronic conditions. Discuss with your doctor about appropriate monitoring strategies.
If you use epinephrine regularly, keep a journal of any reactions post-administration. This can help your doctor tailor your treatment plan effectively.
Frequently asked questions
Is Epinephrine a hormone or neurotransmitter?
Epinephrine, also known as adrenaline, is a hormone and neurotransmitter found naturally in the human body. It is used as a medication for managing several conditions, including anaphylaxis, cardiac arrest, and superficial bleeding.
Does Epinephrine have a steroidal effect?
Epinephrine works primarily by stimulating alpha and beta-adrenergic receptors but has no influence on pathways related to steroid hormones, such as the modulation of inflammation or immune responses associated with corticosteroids.
Can Epinephrine be used to manage asthma?
Historically, Epinephrine was used to manage asthma attacks. However, it has largely been replaced by more selective beta-2 agonists in recent times.
Can Epinephrine increase my blood pressure?
Yes, Epinephrine can increase blood pressure by stimulating alpha-adrenergic receptors, causing blood vessels to constrict (vasoconstriction), and beta-adrenergic receptors, which increase heart rate and the force of heart contractions. This dual effect leads to a rise in both systolic and diastolic blood pressure.
Is Epinephrine available over the counter or do I need a prescription?
Epinephrine is not available over the counter. It is typically administered by a doctor or under their supervision. You should consult your doctor before taking any medication.
Can overdosing on Epinephrine be dangerous?
Yes, an overdose of Epinephrine can lead to severe hypertension (high blood pressure), cerebral haemorrhage (bleeding in the brain), pulmonary oedema (fluid accumulation in the lungs), and cardiac arrhythmias (irregular heartbeats). Immediate medical attention is required in case of an overdose.
Is there any natural alternative to Epinephrine?
There are no natural alternatives that can substitute for the effects of Epinephrine, especially during emergencies like anaphylaxis or cardiac arrest.
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