Each mL contains: Epinephrine 1 mg.
Epinephrine (Adrenaline) is an adrenergic agent as its effects resemble the effects of adrenergic nerve stimulation. It has excitatory action on smooth muscles of the blood vessels in the skin and mucous membranes, inhibitory action on smooth muscles of the wall of the gastrointestinal tract, bronchial tree and blood vessels supplying the skeletal muscles, cardiac excitatory action on the rate and force of contraction, metabolic actions on glycogenolysis in the liver and muscle, modulating action on the secretion of insulin, renin, pituitary hormones and excitatory CNS actions particularly on respiration, wakefulness and feeling of satiety.
The drug of choice for the initial treatment of all anaphylactic reactions except that due to epinephrine itself. Effective as cardiac stimulant in case of collapse, shock and anesthetic accidents. Useful as hemostatic in hemmorhages and prolongs action of infiltration anesthetic agent. Frequently employed in urticaria.
Epinephrine is usually given by intramuscular injection, although it may also be given subcutaneously. In extreme emergencies, where a more rapid effect is required, epinephrine may be given as a dilute solution (1 in 10,000 or 1 in 100,000) by very slow intravenous injection or by slow intravenous infusion. Alternatively, if intravenous access cannot be obtained, it may also be given by the intraosseous (usually into the marrow of the tibia) or endotracheal routes. Epinephrine has sometimes been injected directly in the heart but current guidelines for the management of cardiac emergencies recommend intravenous injection; this may be into a central vein or peripherally, but in the latter case should be followed by 20 mL of intravenous fluid.
The usual dose of epinephrine in anaphylactic shock is 500 micrograms (0.5 mL of a 1 in 1,000 solution) by intramuscular injection repeated as necessary every 5 minutes. A dose of 300 micrograms (0.3 mL of a 1 in 1,000 solution) may be appropriate for emergency self administration, for example by auto injector. The dose for children depends on age and weight, but is usually about 10 micrograms/kg by intramuscular injection.
In advanced cardiac life support the initial dose of epinephrine for adults is 1 mg intravenously (10 mL of a 1 in 10,000 solution) and this may be repeated as often as every 2 to 3 minutes throughout the resuscitation procedure. The dose for children is 10 micrograms/kg intravenously. Higher intravenous doses have been used in both adults and children for the second and subsequent doses but are no longer generally recommended. Intraosseous doses for adults and children are the same as those used intravenously. Endotracheal doses for adults are 2 to 3 times the intravenous dose; children may be given 100 micrograms/kg.
Cardiac arrhythmia, tachycardia of more than 140 beats per minute, severe hypertension, narrow angle glaucoma, during anesthesia with halogenated hydrocarbon of cyclopropane, with local anesthesia of finger or toe, woman in labor, cardiac dilation and coronary insufficiency.
This product contains Sodium bisulfite that may cause allergic type reactions including anaphylactic symptoms and life threatening or less severe asthmatic episodes in certain susceptible persons.
Administered with great caution to elderly patients, to those with cardiovascular disease, severe hypertension, diabetes, hyperthyroidism, and psychoneurosis and to pregnant individuals. Do not use if the solution is discolored or if it shows sediment. Repeated local injections can result in necrosis at the site of injection from vascular constriction. Diphenhydramine, d-chlorpheniramine and other antihistamines may potentiate effects of epinephrine. When the intravenous route is used, the drug must be given very slowly and in a very low concentration.
Epinephrine is a potent sympathomimetic and may exhibit the adverse effects typical of both alpha- and beta-adrenoceptor stimulation. Adverse effects such as anxiety, dyspnoea, hyperglycaemia, restlessness, palpitations, tachycardia (sometimes with angina pain), tremors, sweating, hypersalivation, weakness, dizziness, headache, and coldness of extremities may occur even with low doses. Since epinephrine does not readily cross the blood-brain barrier, its central effects may be largely a somatic response to its peripheral effects. Overdosage may cause cardiac arrhythmias and a sharp rise in blood pressure (sometimes leading to cerebral haemorrhage and pulmonary edema); these effects may occur at normal dosage in susceptible subjects.
Epinephrine is a potent vasoconstrictor and gangrene may occur if epinephrine -containing local anaesthetic solutions are infiltrated into digits. Extravasations of parenteral epinephrine also results in intense vasoconstriction, leading to tissue necrosis and sloughing. Topical application of adrenaline to mucosal surfaces similarly causes vasoconstriction, which may induce hypoxia leading to compensatory rebound congestion of the mucosa. Inhalation of adrenaline has been associated with epigastric pain, which has been attributed to ingestion of some of the inhalation; it can be minimized by rinsing the mouth and throat with water after inhaling.
Epinephrine has direct alpha- and beta-agonist actions and its interactions are complex and may be hazardous. Particular caution is needed if epinephrine is given to patients taking beta blockers since severe hypertension may result; patients taking beta blockers may also have an impaired response to epinephrine if it is needed for anaphylaxis.
Store at temperatures not exceeding 30°C.
C01CA24 - epinephrine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of hypotension.
Ephedrix soln for inj 1 mg/mL
1 mL x 50 × 1's
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