Asthma
Epinephrine is also used as a bronchodilator for asthma if specific β2 agonists are unavailable or ineffective.When given by the subcutaneous or intramuscular routes for asthma, an appropriate dose is 0.3 to 0.5 mg.Because of the high intrinsic efficacy (receptor binding ability) of epinephrine, high drug concentrations cause adverse side effects when treating asthma. The value of using nebulized epinephrine in acute asthma is unclear. Croup
Racemic epinephrine has historically been used for the treatment of croup. Regular epinephrine, however, works equally well. Racemic adrenaline is a 1:1 mixture of the two enantiomers of adrenaline. The L-form is the active component. Racemic adrenaline works by stimulating the alpha-adrenergic receptors in the airway, with resultant mucosal vasoconstriction and decreased subglottic edema, and by stimulating the β adrenergic receptors, with resultant relaxation of the bronchial smooth muscle. Bronchiolitis
There is a lack of consensus as to whether inhaled nebulized epinephrine is beneficial in the treatment of bronchiolitis, with most guidelines recommending against its use. Local anesthetics
When epinephrine is mixed with local anesthetics, such as bupivacaine or lidocaine, and used for local anesthesia or intrathecal injection, it prolongs the numbing effect and motor block effect of the anesthetic by up to an hour. Epinephrine is frequently combined with local anesthetic and can cause panic attacks.Epinephrine is mixed with cocaine to form Moffetts solution, used in nasal surgery. Upper airway obstruction
Upper airway obstruction with edema and stridor can be treated with racemic epinephrine. Adverse effects
Adverse reactions to adrenaline include palpitations, tachycardia, arrhythmia, anxiety, panic attack, headache, tremor, hypertension, and acute pulmonary edema.
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