Brands, Medical Use, Clinical Data
- Vasoconstrictor Agents
- Bronchodilator Agents
- Metered-dose (aerosol)
- Pellet (dental)
Brands / Synonyms
Adnephrine; Adrenaclick; Adrenal; Adrenalin; Adrenalin Chloride; Adrenalin in Oil; Adrenalin-Medihaler; Adrenalina [Dcit]; Adrenaline; Adrenaline/Epinephrine; Adrenalinum; Adrenamine; Adrenan; Adrenapax; Adrenasol; Adrenatrate; Adrenine; Adrenodis; Adrenohorma; Adrenor; Adrenosan; Adrenutol; Adrin; Adrine; ADROP; Aktamin; Ana-Guard; Antiasthmatique; Arterenol; Asmatane Mist; Asthma Meter Mist; Asthma-Nefrin; Asthmahaler Mist; Asthmanefrin; Astmahalin; Astminhal; Balmadren; Bernarenin; Biorenine; Bosmin; Brevirenin; Bronkaid; Bronkaid Mist; Bronkaid Suspension Mist; Bupivacaine and Epinephrine; Bupivacaine Hcl and Epinephrine; Chelafrin; Citanest Forte; Corisol; D-Adrenaline; D-Epifrin; D-Epinephrine; Drenamist; Duranest; Dylephrin; Dyspne-Inhal; Epi EZ Pen Jr; Epifrin; Epiglaufrin; Epinefrin; Epinefrin [Czech]; Epinefrina; Epinefrina [Inn-Spanish]; Epinephran; Epinephrine Bitartrate; Epinephrine [Usan:Inn:Jan]; Epinephrinum [Inn-Latin]; Epipen; Epipen Auto-Injector; Epipen EZ Pen; Epipen Jr.; Epipen Jr. Auto-Injector; Epirenamine; Epirenan; Epirenin; Epitrate; Eppy; Esphygmogenina; Exadrin; Glaucon; Glaucosan; Glauposine; Glycirenan; Haemostasin; Haemostatin; Hektalin; Hemisine; Hemostasin; Hemostatin; Hypernephrin; Hyporenin; Intranefrin; Iontocaine; IOP; Isoptoepinal; Kidoline; L-Adrenalin; L-Adrenaline; L-Adrenaline Base; L-Adrenaline Gr; L-Arterenol; L-Epinephine; L-Epinephrine; L-Epirenamine; L-Methylaminoethanolcatechol; L-Noradrenaline; L-Norepinephrine; Levarterenol; Levo-Methylaminoethanolcatechol; Levoarterenol; Levoepinephrine; Levonor; Levonoradrenaline; Levonorepinephrine; Levophed; Levorenen; Levorenin; Levorenine; Lidocaine and Epinephrine; Lidocaton; Lidosite; Lyophrin; Medihaler-Epi; Metanephrin; Methylaminoethanolcatechol; Methylarterenol; Micronefrin; Mucidrina; Myosthenine; Mytrate; Nephridine; Nephron; Nieraline; Nor-Epirenan; Noradrenalin; Noradrenaline; Norartrinal; Norepinephrine; Norepinephrine Bitartrate; Norepirenamine; Octocaine; Paranephrin; Prilocaine and Epinephrine; Primatene Mist; Renagladin; Renaglandin; Renaglandulin; Renaleptine; Renalina; Renoform; Renostypricin; Renostypticin; Renostyptin; Scurenaline; Septocaine; Simplene; Sindrenina; Soladren; Sphygmogenin; Stryptirenal; Styptirenal; Supracapsulin; Supradin; Supranefran; Supranephrane; Supranephrine; Supranol; Suprarenaline; Suprarenin; Suprel; Surenine; Surrenine; Sus-Phrine; Susphrine; Sympathin E; Sympathin I; Takamina; Takamine; Tokamina; Tolansin; Tolax; Tolcil; Tolhart; Tonogen; Twinject; Twinject 0.30; Vaponefrin; Vasoconstrictine; Vasoconstrictor; Vasodrine; Vasoton; Vasotonin
For the treatment of anaphylactic reactions
Epinephrine is indicated for intravenous injection in treatment of acute hypersensitivity, treatment of acute asthmatic attacks to relieve bronchospasm, and treatment and prophylaxis of cardiac arrest and attacks of transitory atrioventricular heart block with syncopal seizures (Stokes-Adams Syndrome). The actions of epinephrine resemble the effects of stimulation of adrenergic nerves. To a variable degree it acts on both alpha and beta receptor sites of sympathetic effector cells. Its most prominent actions are on the beta receptors of the heart, vascular and other smooth muscle. When given by rapid intravenous injection, it produces a rapid rise in blood pressure, mainly systolic, by (1) direct stimulation of cardiac muscle which increases the strength of ventricular contraction, (2) increasing the heart rate and (3) constriction of the arterioles in the skin, mucosa and splanchnic areas of the circulation. When given by slow intravenous injection, epinephrine usually produces only a moderate rise in systolic and a fall in diastolic pressure. Although some increase in pulse pressure occurs, there is usually no great elevation in mean blood pressure. Accordingly, the compensatory reflex mechanisms that come into play with a pronounced increase in blood pressure do not antagonize the direct cardiac actions of epinephrine as much as with catecholamines that have a predominant action on alpha receptors.
Mechanism of Action
Epinephrine works via the stimulation of alpha and beta-1 adrenergic receptors, and a moderate activity at beta-2 adrenergic receptors.
Usually this vasodilator effect of the drug on the circulation predominates so that the modest rise in systolic pressure which follows slow injection or absorption is mainly the result of direct cardiac stimulation and increase in cardiac output.
Skin, LD50 = 62 mg/kg (rat)
Biotrnasformation / Drug Metabolism
Epinephrine is contraindicated in patients with known hypersensitivity to sympathomimetic amines, in patients with
angle closure glaucoma, and patients in shock (nonanaphylactic). It should not be used in patients anesthetized with
agents such as cyclopropane or halothane as these may sensitize the heart to arrhythmic action of sympathomimetic
Epinephrine should not ordinarily be used in those cases where vasopressor drugs may be contraindicated, e.g., in
thyrotoxicosis, diabetes, in obstetrics when maternal blood pressure is in excess of 130/80 and in hypertension and
other cardiovascular disorders.
Epinephrine should be used cautiously in patients with hyperthyroidism, hypertension and cardiac arrhythmias. All
vasopressors should be used cautiously in patients taking monoamine oxidase (MAO) inhibitors.
Epinephrine should not be administered concomitantly with other sympathomimetic drugs (such as isoproterenol)
because of possible additive effects and increased toxicity.
Combined effects may induce serious cardiac arrhythmias. They may be administered alternately when the preceding
effect of other such drug has subsided.
Administration of epinephrine to patients receiving cyclopropane or halogenated hydrocarbon general anesthetics
such as halothane which sensitize the myocardium, may induce cardiac arrhythmia.. When encountered, such arrhythmias
may respond to administration of a beta-adrenergic blocking drug. Epinephrine also should be used cautiously with
other drugs (e.g., digitalis, glycosides) that sensitize the myocardium to the actions of sympathomimetic drugs.
Diuretic agents may decrease vascular response to pressor drugs such as epinephrine.
Epinephrine may antagonize the neuron blockade produced by guanethidine resulting in decreased antihypertensive
effect and requiring increased dosage of the latter.