Medical uses
Epinephrine is used to treat a number of conditions, including cardiac arrest, anaphylaxis, and superficial bleeding. It has been used historically for bronchospasm and low blood sugar, but newer treatments for these that are selective for β2 adrenoceptors, such as salbutamol, are currently preferred. Heart problems
While epinephrine is often used to treat cardiac arrest, it has not been shown to improve long-term survival or mental function after recovery. It does, however, improve return of spontaneous circulation. When used intravenously, epinephrine is typically given every three to five minutes.Epinephrine infusions may also be used for symptomatic bradycardia. Anaphylaxis
Epinephrine is the drug of choice for treating allergic reaction anaphylaxis. The commonly used epinephrine autoinjector delivers a 0.3 mg epinephrine injection (0.3 mL, 1:1000). It is indicated in the emergency treatment of allergic reactions, including anaphylaxis to stings, contrast agents, medicines, or people with a history of anaphylactic reactions to known triggers. A single dose is recommended for people who weigh 30 kg or more, repeated if necessary. A lower-strength product is available for children.Intramuscular injection can be complicated in that the depth of subcutaneous fat varies and may result in subcutaneous injection, or may be injected intravenously in error, or the wrong strength used. Intramuscular injection gives a faster and higher pharmacokinetic profile compared to subcutaneous injection.
The goal of reducing peripheral circulation is to increase coronary and cerebral perfusion pressures and therefore increase oxygen exchange at the cellular level. While epinephrine does increase aortic, cerebral, and carotid circulation pressure, it lowers carotid blood flow and end-tidal CO2 or ETCO2 levels. It appears that epinephrine may improve macrocirculation at the expense of the capillary beds where perfusion takes place. History
Extracts of the adrenal gland were first obtained by Polish physiologist Napoleon Cybulski in 1895. These extracts, which he called nadnerczyna, contained adrenaline and other catecholamines. American ophthalmologist William H. Bates discovered adrenalines usage for eye surgeries prior to 20 April 1896. Japanese chemist Jōkichi Takamine and his assistant Keizo Uenaka independently discovered adrenaline in 1900. In 1901, Takamine successfully isolated and purified the hormone from the adrenal glands of sheep and oxen. Adrenaline was first synthesized in the laboratory by Friedrich Stolz and Henry Drysdale Dakin, independently, in 1904. Society and culture
Brand names
Common brand names include Asthmanefrin, Micronefrin, Nephron, VapoNefrin, and Primatene Mist. Delivery forms
Epinephrine is available in an autoinjector delivery system. There is an epinephrine metered-dose inhaler sold over the counter in the United States to relieve bronchial asthma. It was introduced in 1963 by Armstrong Pharmaceuticals.A common concentration for epinephrine is 2.25% w/v epinephrine in solution, which contains 22.5 mg/mL, while a 1% solution is typically used for aerosolization. Adults: 0.5–0.75 ml of a 2.25% solution in 2.0 ml normal saline. Pediatrics: 0.25–0.75 ml of a 2.25% solution in 2.0 ml normal saline. References
External links
"Epinephrine". Drug Information Portal.