EPINEPHRINE (ADRENALINE)

Sympathomimetic agent that relieves symptoms of severe allergic reactions, such as difficulty in breathing and lowering in blood pressure

Dosage forms

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Injection

1 mg/ml

Uses

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  • Anaphylactic shock (acute hypersensitivity reaction )
  • Severe allergic reactions
  • Cardiopulmonary arrest

Dose and duration

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All uses
Adult: 0.5–1 mg IM in the outer upper thigh. Repeat every 10 minutes according to blood pressure, pulse rate, and respiratory function until improvement occurs.
Child: Give dose according to table below in the outer upper thigh. Repeat every 10 minutes according to blood pressure, pulse rate, and respiratory function until improvement occurs.
Age (years) Volume of Adrenaline (ml)
Normal Underweight
<1 0.05 0.05
1 0.1 0.10
2 0.2 0.10
3-4 0.3 0.15
5 0.4 0.20
6-12 0.5 0.25
> 12 0.5-1 0.5-1

Repeat adrenaline every 2–6 hours as need arises depending on the patient's progress

Side effects

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  • Irregular heartbeat, high blood pressure
  • Shaking, sweating, headache, anxiety
  • Stomach upset

Interactions

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  • Propranolol (cancelled effect; see caution)
  • Atenolol (cancelled effect; see caution)

Pregnancy

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  • Can be used

Breast-feeding

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  • Can be used

⚠️ Caution

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  • Solution should be colourless; do not use any solution with a pink or brownish colour
  • Patients on propranolol and atenolol may be resistant to the effects of epinephrine; use salbutamol IV instead
  • Do not exceed indicated dose; risk of Irregular heartbeat
  • IM route is the first choice as there is rapid absorption and is more reliable than SC
  • The IV route should only be used if the patient has poor circulation. Injection is given slowly (over 5 minutes)
  • Adrenaline may delay 2ⁿᵈ stage of labour and may cause anoxia in the foetus. Only use if benefit outweighs risk