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EPINEPHRINE is a brand name for Epinephrine (also known as Adrenaline), supplied as a solution. The medicine, its uses, side effects and dosage are the same regardless of brand.
Verbatim from this product's HC label. Tap a section to expand.
Epinephrine is contraindicated in patients with known hypersensitivity to sympathomimetic amines, in patients with angle closure glaucoma, and patients in shock (nonanaphylactic). It should not be used in patients anesthetized with agents such as cyclopropane or halothane as these may sensitize the heart to arrhythmic action of sympathomimetic drugs.
g. in thyrotoxicosis, diabetes, patients receiving MAO inhibitors, in obstetrics when maternal blood pressure is in excess of 130/80 or during labour, and in hypertension and other cardiovascular disorders. WARNINGS Inadvertently induced high arterial blood pressure may result in angina pectoris, aortic rupture or cerebral hemorrhage.
Epinephrine may induce potentially serious cardiac arrhythmias in patients not suffering from heart disease and patients with organic heart disease or who are receiving drugs that sensitize the myocardium. Parenterally administered epinephrine initially may produce constriction of renal blood vessels and decrease urine formation, and large doses may cause complete renal shutdown.
Epinephrine and Beta-blockers There may be increased difficulty in treating an allergic-type reaction in patients on beta- blockers. In these patients, the reaction may be more severe due to pharmacologic effects of the beta- blockers and problems with fluid changes (see PRECAUTIONS-Drug Interactions).
PRECAUTIONS Although epinephrine can produce ventricular fibrillation, its actions in restoring electrical activity in asystole and in enhancing defibrillation of the fibrillating ventricle are well documented. The drug, however, should be used with caution in patients with ventricular fibrillation.
5 In patients with prefibrillatory rhythm, intravenous epinephrine must be used judiciously, with extreme caution, because of its excitatory action on the heart. Since the myocardium is sensitized to this action of the drug by many anesthetic agents, epinephrine may convert asystole to ventricular fibrillation if used in the treatment of anesthetic cardiac accidents.
Epinephrine should be used cautiously in the elderly and in patients with hyperthyroidism, hypertension, diabetes and cardiac diseases/arrhythmias. Patients with long-standing bronchial asthma and emphysema, who have developed degenerative heart disease, should be administered the drug with extreme caution.
Fatalities may also result from pulmonary edema because of the peripheral constriction and cardiac stimulation produced. Rapidly acting vasodilators such as nitrites, or alpha-blocking agents may counteract the marked pressor effects of epinephrine.
Drug Interactions Beta-blockers There may be increased difficulty in treating an allergic-type reaction in patients on beta- blockers. In these patients, the reaction may be more severe due to pharmacologic effects of the beta- blockers and problems with fluid changes.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Brand names are compiled from public regulatory records for active-ingredient mapping only. Drugvu is not affiliated with any manufacturer. This is not medical advice.
Epinephrine should be administered with caution, since it may not have its usual effects in the treatment of anaphylaxis. On the one hand, larger doses of epinephrine may be needed to overcome the bronchospasm, while on the other, these doses can be associated with excessive alpha-adrenergic stimulation with consequent hypertension, reflex bradycardia and heart-block and possible potentiation of bronchospasm.
Alternatives to the use of large doses of epinephrine include vigorous supportive care such as fluids and the use of beta agonists including parenteral salbutamol or isoproterenol to overcome bronchospasm and norepinephrine to overcome hypotension.
Sympathomimetic Drugs Epinephrine should not be administered concomitantly with other sympathomimetic drugs (such as isoproterenol) because of possible additive effects and increased toxicity. Combined effects may induce serious cardiac arrhythmias.
They may be administered alternately when the preceding effect of another such drug has subsided. Cyclopropane or Halogenated Hydrocarbons Administration of epinephrine to patients receiving cyclopropane or halogenated hydrocarbon general anesthetics such as halothane, which sensitize the myocardium, may induce cardiac arrhythmias (see CONTRAINDICATIONS).
When encountered, such arrhythmias may respond to administration of a beta-adrenergic blocking drug. 6 Diuretics Diuretic agents may decrease vascular response to pressor drugs such as epinephrine. Guanethidine Epinephrine may antagonize the neuron blockade produced by guanethidine, resulting in decreased antihypertensive effect and requiring increased dosage of the latter.
MAO Inhibitors All vasopressors should be used cautiously in patients taking monoamine oxidase (MAO) inhibitors (see CONTRAINDICATIONS). g. diphenhydramine, tripelennamine, chlorpheniramine; and sodium levothyroxine. g. digitalis glycosides) that sensitize the myocardium to the actions of sympathomimetic drugs.
Pregnancy Epinephrine has been shown to be teratogenic in rats when given in doses about 25 times the human doses. It is not known whether epinephrine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.
Epinephrine should be given to a pregnant woman only if clearly needed. Labor and Delivery Parenteral administration of epinephrine, if used to support blood pressure during low or other spinal anesthesia for delivery, can cause acceleration of fetal heart rate and should not be used in obstetrics when maternal blood pressure exceeds 130/80 (see CONTRAINDICATIONS).
Epinephrine may delay the second stage of labour. ADVERSE REACTIONS Transient and minor side effects of anxiety, headache, fear and palpitations may occur with systemic therapeutic doses, especially in hyperthyroid individuals. Adverse effects, such as cardiac arrhythmias […]
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