Introduction

Name

• Epinephrine.

Class of drug

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

Description

Molecular formula

• C₉H₁₃NO₃.

Molecular weight

• 183.2.

Physical properties

• White to nearly white microcrystalline powder or granules.
• Very slightly soluble in water, but it readily forms water-soluble salts, eg HCl, when combined with acids.

Storage requirements

• Store in tight containers, protected from air and light.
• Do not use the injection if it is pink, brown or contains a precipitate.
• Stability of injectable solution may depend on manufacturer.

Uses

Indications

• Primarily used in the treatment of anaphylaxis and in cardiac resuscitation.
• Because of its vasoconstrictive properties, epinephrine is also added to local anesthetics to retard systemic absorption and prolong effect.
• Also useful to stop small hemorrhages.

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, diphenhydramine, and thyroxine.
• 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, high doses of digoxin Digoxin, monitor for signs of arrhythmias.
• Try to avoid the use of epinephrine in halothane-anesthetized animals.
• Hypertension may result if epinephrine is used with oxytocic agents Oxytocin.

Adverse Reactions

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Schenellbacher R, Olson E E & Mayer J (2012) Emergency presentations associated with cardiovascular disease in exotic herbivores. J Exotic Pet Med 21 (4), 316-327 VetMedResource.

Other sources of information

• Meredith A (2015) Ed BSAVA Small Animal Formulary. Part B: Exotic Pets. 9th edn. BSAVA, UK.
• Plumb D (2015) Plumb’s Veterinary Drug Handbook. 8th edn. Wiley Blackwell. pp 1296.
• Bishop Y (1998) The Veterinary Formulary. 4th edn. British Veterinary Association and Royal Pharmaceutical Society.
• Flecknell P A (1996) Laboratory Animal Anaesthesia. 2nd edn. Academic Press.

Organisation(s)

• National Office of Animal Health (NOAH) Compendium of Data Sheets for Animal Medicines. Website: www.noahcompendium.co.uk.