Epinephrine: functions, dosage, side effects, how to use it

What medicine is Epinephrine?

What is Epinephrine for?

This medication is used in an emergency to treat very serious allergic reactions such as insect stings / bites, food, drugs, or other substances. Epinephrine acts quickly to improve breathing, stimulate the heart, increase decreased blood pressure, relieve itching, and reduce swelling of the face, lips, and throat.

How is Epinephrine taken?

Different brands of this drug have different instructions for preparing and using the injection device. Learn how to properly inject this drug from the start so that you will be ready when you really need to use it. Additionally, teach your family member or caregiver what to do if you are unable to give yourself a shot. Read the patient information leaflet provided by your pharmacist before you use Epinephrine and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

This drug has a quick but not long lasting effect. After an epinephrine injection, seek immediate medical help. Tell the doctor who has given the epinephrine injection. Avoid accidentally injecting this drug into your hands or any area of ​​your body other than your thighs. If this happens, notify your healthcare professional immediately. Dispose of injectors properly.

The solution of this product must be clean. Visually inspect this product for particles or discoloration from time to time. If it has turned cloudy or pink / brown, do not use the product. Get a new product.

Follow the rules given by your doctor or pharmacist before starting treatment. If you have any questions, consult your doctor or pharmacist.

How is Epinephrine stored?

Keep this product close to you.

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Epinephrine dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dose of Epinephrine for adults?

Usual Adult Dose for Shock

IV: 2-10 mcg / min (1 mg in 250 mL D5W or 4 mcg / mL). May increase if needed to establish an adequate heart rate and blood pressure. Doses of 20 mcg / minute are rarely required.

Endotracheal: 1 mg (10 mL 1: 10,000) once, followed by 5 rapid insufflations.

Intracardial: 0.3-0.5 mg (3-5 ml 1: 10,000) by direct injection into the left ventricular space once.

Usual Adult Dose for Asystole

IV: 0.5-1 mg (5 to 10 mL 1: 10,000) once.

Can be repeated every 3-5 minutes as needed.

If there is not an adequate response to 1 mg, then apply a high dose (2-5 mg) every 3 to 5 minutes, increasing by 1, 3, then 5 mg every 3 minutes, or 0.1 mg / kg every 3 to 5 minutes. , has been used.

Endotracheal: 1 mg (10 mL 1: 10,000) once, followed by 5 rapid insufflations.

Intracardial: 0.3-0.5 mg (3-5 ml 1: 10,000) by direct injection into the left ventricular space once.

Usual Adult Dose for Electromechanical Dissociation

IV: 0.5-1 mg (5 to 10 mL 1: 10,000) once.

Can be repeated every 3-5 minutes as needed.

If there is an inadequate response to 1 mg, then high-dose therapy (2-5 mg) every 3 to 5 minutes, increasing by 1, 3, then 5 mg every 3 minutes, or 0.1 mg / kg every 3 to 5 minutes , has been used.

Endotracheal: 1 mg (10 mL 1: 10,000) once, followed by 5 # rapid insufflations.

Intracardial: 0.3-0.5 mg (3-5 ml 1: 10,000) by direct injection into the left ventricular space once.

Usual Adult Dose for Cardiac AV Blockage

IV: 0.5-1 mg (5 to 10 mL 1: 10,000) once.

Can be repeated every 3-5 minutes if needed.

If there is not an adequate response to 1 mg, then high dose (2–5 mg) every 3 to 5 minutes, increasing by 1, 3, then 5 mg every 3 minutes, or 0.1 mg / kg every 3 to 5 minutes , has been used.

Usual Adult Dose for Asthma - Acute:

Subcutaneous: 0.1 to 0.5 mg (0.1 to 0.5 ml of 1: 1000 solution). Can be repeated every 20 minutes for once every 4 hours as needed.

Subcutaneous suspension: 0.5 mg (0.1 mL 1: 200 suspension) once. Additional doses of 0.5-1 mg can be given as needed but no more than every 6 hours.

IM: 0.1 to 0.5 mg (0.1 to 0.5 ml of 1: 1000 solution). Can be repeated every 20 minutes for once every 4 hours as needed.

Aerosol inhalation: 160-220 mcg (1 inhalation) once. Additional inhalations can be used after at least a minute. It is recommended that the next dose is not given for at least three hours.

Nebulized: 1-3 inhalations (8-10 drops of 1: 100% solution) once. If help is not available within 5 minutes, the dose can be repeated once. It is recommended that the next dose is not repeated more often than every 3 hours.

Inhalation intermittent positive pressure: 0.3 mg (0.03 mL of 1: 100 solution) once. The minimum tolerable number of inhalations needed to provide relief is the recommended dosage. Most patients respond within 15 minutes. This dose can be repeated every 3 to 4 hours as needed.

Usual Adult Dose for Chronic Obstructive Pulmonary Disease - Acute:

Subcutaneous: 0.3 mg (0.3 ml 1: 1000) every 20 minutes for up to 3 doses. Can be repeated every 2 hours as needed.

IM: 0.1 to 0.5 mg (0.1 to 0.5 ml 1: 1000) once. Can be repeated every 20 minutes to 4 hours as needed.

Aerosol inhalation: 160-220 mcg (1 inhalation) once. Additional inhalations can be used after at least a minute. It is recommended that the next dose is not given for at least three hours.

Nebulized: 1-3 inhalations (8-15 drops of 1% 1: 100 solution or 2.25% racEpinephrine solution) once. If help is not available within 5 minutes, the dose can be repeated once. It is recommended that the next dose is not repeated more often than every 3 hours.

Positive intermittent respiratory pressure: 0.3 mg (0.03 mL of 1: 100 solution) once. The minimum number of inhalations tolerated and required to provide relief is the recommended dosage. Most patients respond within 15 minutes. This dose can be repeated every 3 to 4 hours as needed.

Usual Adult Dose for Allergic Reactions:

Subcutaneous: 0.1 to 0.5 mg (0.1 to 0.5 ml of 1: 1000 solution). Can be repeated every 20 minutes for once every 4 hours as needed.

Subcutaneous suspension: 0.5 mg (0.1 mL 1: 200 suspension) once. Additional doses of 0.5-1 mg can be given as needed but no more frequently than every 6 hours.

IM: 0.1 to 0.5 mg (0.1 to 0.5 ml of 1: 1000 solution). Can be repeated every 10 to 15 minutes.

IV: 0.1-0.25 mg (1 to 2.5 ml of 1: 10,000 solution) once slowly and carefully for 5 to 10 minutes. The dose can be repeated every 5 to 15 minutes as needed and can be tolerated. In some cases of severe anaphylaxis, intravenous infusion of epinephrine (1 mg in 250 mL D5W, or 4 mcg / mL) may be started at 1 to 4 mcg / minute (15 to 60 mL / hour).

Usual Adult Dose for Pupil Dilation:

Induction and Maintenance of Mydriasis during Intraocular Surgery:

-Use the solution required for surgical procedures

-Intractively inject 0.1 ml bolus dose diluted at a concentration of 1: 100,000 to 1: 400,000 (10 mcg / mL 2.5 mcg / ml)

What is the dosage of Epinephrine for children?

Usual Children's Dose for Asistol:

Neonates:

IV or intratracheal: 0.01-0.03 mg / kg (0.1-0.3 mL / kg of 1: 10,000) every 3 to 5 minutes if needed. Dilute the intratracheal dose in 1 to 2 ml of plain saline.

Infants and children:

IV: Initial dose: 0.01 mg / kg (0.1 mL / kg of 1: 10,000). Can be repeated every 3 to 5 minutes. Maximum dose: 1 mg or 10 mL.

Intratracheal: 0.1 mg / kg (0.1 ml of 1: 1000 solution). Doses as high as 0.2 mg / kg may be effective. Can be repeated every 3 to 5 minutes.

Usual Children's Dose for Shock:

Neonates:

IV or intratracheal: 0.01-0.03 mg / kg (0.1-0.3 mL / kg of 1: 10,000) every 3 to 5 minutes as needed. Dilute the intratracheal dose in 1 to 2 ml of plain saline water.

Infants and children:

IV: Initial dose: 0.01 mg / kg (0.1 mL / kg of 1: 10,000). Can be repeated every 3 to 5 minutes. Maximum dose: 1 mg or 10 mL.

Intratracheal: 0.1 mg / kg (0.1 ml solution 1: 1000). Doses as high as 0.2 mg / kg may be effective. Can be repeated every 3 to 5 minutes.

Usual Children's Dose for Allergic Reactions:

2-year-old infant: 0.05-0.1 mL IM or subcutaneously from a 1: 1000 solution. If after 10 minutes from the first injection the symptoms do not feel better, give a second dose.

Children:

2-5 years: 0.15 ml IM or subcutaneously

6-11 years: 0.2 ml IM or subcutaneously

12 years older: 0.3 mL IM or subcutaneously

If after 10 minutes from the first injection your symptoms do not feel better, give a second dose.

Alternative subcutaneous dose: 0.01 mg / kg (0.01 mL / kg / 1: 1000 solution dose) not to exceed 0.5 mg.

Subcutaneous suspension: 0.025 mg / kg (0.005 mL / kg of 1: 200) once. Do not exceed 0.15 ml every 8 to 12 hours.

Usual Children's Dose for Asthma - Acute:

2-year-old infant: 0.05-0.1 mL IM or subcutaneously from a 1: 1000 solution. If after 10 minutes from the first injection the symptoms do not feel better, give a second dose.

Children:

2-5 years: 0.15 ml IM or subcutaneously

6-11 years: 0.2 ml IM or subcutaneously

12 years or older: 0.3 mL IM or subcutaneously

If after 10 minutes from the first injection your symptoms do not feel better, give a second dose.

Alternative subcutaneous dose: 0.01 mg / kg (0.01 mL / kg / 1: 1000 solution dose) not to exceed 0.5 mg.

Subcutaneous suspension: 0.025 mg / kg (0.005 mL / kg of 1: 200 suspension) not to exceed 0.15 ml every 8 to 12 hours.

4 years or more:

Aerosol inhalation: 220 mcg (1 inhalation) once. Additional inhalations can be used after at least a minute. It is recommended that the next dose is not given for at least three hours.

Usual Children's Dose for Pupil Dilation:

Induction and Maintenance of Mydriasis during intraocular surgery:

-Use the solution required for surgical procedures

-Intractively inject 0.1 ml bolus dose diluted at a concentration of 1: 100,000 to 1: 400,000 (10 mcg / mL 2.5 mcg / ml).

In what dosage is Epinephrine available?

Device, injection: 0.15mg / 0.15 m, 0.3 mg / mL 0.3, 0.15 mg / mL 0.3

Nebulization solution, Inhalation: 2.25%

Solution, injection: 0.1 mg / mL (10 mL); 1 mg / mL (1 mL)

Karutan, injectable, as hydrochloride: 1 mg / mL

Epinephrine side effects

What side effects can I experience due to Epinephrine?

Before using Epinephrine for the second time, call your doctor if your first injection causes serious side effects such as increased difficulty breathing, or dangerously high blood pressure (severe headache, blurred vision, ringing in the ears, anxiety, confusion, chest pain, tightness. breath, uneven heartbeat, convulsions).

Less serious side effects may include:

• Sweating
• Nausea and vomiting
• Pale skin
• Feel short of breath
• Dizzy
• Weakness or tremors
• Headache or
• Feeling nervous or anxious

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Epinephrine Drug Warnings and Cautions

What should be known before using Epinephrine?

Before using Epinephrine,

• • Tell your doctor and pharmacist if you are allergic to epinephrine, other drugs, sulfides or any of the other ingredients in epinephrine injections. Your doctor may tell you to use epinephrine injection even if you are allergic to one of the ingredients because it is a life-saving drug. Automatic injection epinephrine kits contain no latex and are safe to use if you have a latex allergy.
  • Tell your doctor and pharmacist about prescription and nonprescription drugs, vitamins, nutritional supplements, and herbal products that you are using or will be using. Be sure to mention the following: certain antidepressants such as amitriptyline (Elavil), amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), Maprotiline, mirtazapine (Remeron), protriptyline (Pameltyline) Vivactil), and trimipramine (Surmontil); antihistamines such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl); beta blockers such as propranolol (Inderal); digoxin (Digitek, Lanoxicaps, Lanoxin); diuretics ('water pills'); ergot drugs such as dihydroergotamine (DHE 45, Migranal), ergoloid mesylates (Hydergine), ergonovin (Ergotrate), ergotamine (at Cafergot, in Migergot), methylergonovin (Methergine), and methysergide (Sansert); levothyroxine (Levothroid, Levoxyl, Synthroid, Unithroid); and medications for irregular heartbeats such as quinidine. Also tell your doctor if you are taking monoamine oxidase inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) or have stopped using the drug in the past two weeks. Your doctor may need to change the dose of your medication or monitor you carefully for side effects
  • Tell your doctor if you have or have ever had chest pain, irregular heartbeat, high blood pressure, or other heart disease. diabetes; hyperthyroidism (overactive thyroid); depression or other mental illness; or Parkinson's disease. If you are going to be using the Twinject device then tell your doctor if you have arthritis or have difficulty using your hands.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Talk with your doctor about whether and when you should use epinephrine injections if you are pregnant.

Is Epinephrine safe for pregnant and breastfeeding women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

Studies in women show that this drug poses minimal risk to the baby when used during breastfeeding.

Epinephrine Drug Interactions

What medicines may interact with Epinephrine?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Although some drugs should not be taken at the same time, in other cases some drugs can also be used together even though interactions may occur. In such cases, the doctor may change the dose, or take other preventive measures as needed. Tell your doctor if you are taking any other over-the-counter or prescription drugs.

Can food or alcohol interact with Epinephrine?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions can interact with Epinephrine?

The presence of other health problems in your body may affect the use of this drug. Tell your doctor if you have other health problems .:

• Bronchial asthma
• Diabetes mellitus type 2
• Eye disease
• Heart or vascular disease
• High blood pressure or
• Overactive thyroid - Epinephrine can make the condition worse
• Dental or gum surgery - Dental surgery may use epinephrine in the form of a topical or injection. The use of ophthalmic epinephrine during this time can increase drug levels and increase the chance of side effects

Epinephrine overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.