Introduction

Name

• Epinephrine.

Class of drug

• Catecholamine with both alpha- and beta-adrenergic activity.

Description

Chemical name

• (R)-4-[1-hydroxy-2-(methylamino)ethyl]-1,2-benzenediol.
• (-)-3,4-dihydroxy-alpha-[(methylamino)methyl] benzyl alcohol.

Molecular formula

• C9H13NO3.

Physical properties

• Solution.

Storage requirements

• Epinephrine is sensitive to light and air, and is unstable in 5% dextrose.
• Store in a dark-colored bottle or keep in box.

Uses

Indications

• Primarily used in the treatment of anaphylaxis Anaphylaxis, urticaria and angioedema and in cardiac resuscitation Cardiopulmonary resuscitation.

Administration

Pharmacokinetics

Precautions

Interactions

with other drugs

• Toxicity may occur if used with other sympathomimetic amines, eg isoproterenol because of additive effects.
• The effects of epinephrine may be potentiated by antihistamines, eg chlorpheniramine Chlorphenamine , diphenhydramine Diphenhydramine , and thyroxine.
• Propranolol Propranolol may block the beta effects of epinephrine, thus facilitating an increase in blood pressure.
• Alpha-blocking agents or diuretics may negate or diminish the pressor effects of epinephrine.
• When epinephrine is used with drugs that sensitize the myocardium, eg halothane Halothane , high doses of digoxin Digoxin , monitor for signs of arrhythmias.
• Try to avoid the use of epinephrine in halothane anesthetized animals Halothane.
• Hypertension may result if epinephrine is used with oxytocic agents Oxytocin.

Adverse Reactions

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.

Other sources of information

• Rosanski E A, Rush J E, Buckley G J, Fletcher D J, Boller M; RECOVER Advanced Life Support Domain Worksheet Authors (2012) RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 4: Advanced life support. J Vet Emerg Crit Care (San Antonio) 22 (Suppl 1), S44-64 PubMed.
• Based on Small Animal Formulary. Tennant Bryn (1999) 3rd edn. Cheltenham: BSAVA.