Epinephrine administration

Alternative Routes of Epinephrine Administration for First-Aid Treatment... 

Epinephrine also has been used to lower intraocular pressure in open-angle glaucoma. Its use promotes an increase in the outflow of aqueous humor. Because epinephrine administration will decrease the filtration angle formed by the cornea and the iris, its use is contraindicated in angle-closure glaucoma under these conditions the outflow of aqueous humor via the filtration angle and into the venous system is hindered, and intraocular pressure may rise abruptly. 

Describe the pharmacological uses of ephedrine and its advantages over epinephrine administration. 

Intussusception Crush syndrome Epinephrine administration Ergot poisoning General Cardiac arrest... 

The nurse may administer epinephrine subcutaneously for an acute bronchospasm. Therapeutic effects occur within 5 minutes after administration and last as long as 4 hours. 

In this review, we will describe the pharmacologic activity of epinephrine in anaphylaxis, the evidence base for its use, epinephrine dosing and routes of administration, epinephrine autoinjector use in first-aid treatment, reasons for failure to inject epinephrine promptly, reasons for occasional apparent lack of response, and future directions in epinephrine research. 

Given the unexpected occurrence of anaphylaxis, the rapidity with which symptoms evolve after exposure to the trigger, and the observation that delay in epinephrine injection is associated with fatality [15, 16], randomized controlled trials of epinephrine in anaphylaxis will not be easy to conduct however, it is time to consider the possibility of performing such trials. Future directions with regard to studies of the optimal dose and optimal route of administration of epinephrine in anaphylaxis that do not involve a placebo control will be outlined at the end of this review [17]. 

Avakian, E.V., and Manneh, V.A. Cardiac responsivity to epinephrine following chronic cocaine administration. Proc West Pharmacol Soc 30 281-284, 1987. 

Acute treatment of patients with second- or third-degree AV nodal blockade consists primarily of administration of atropine, which maybe administered in the same doses as recommended for management of sinus bradycardia. In patients with hemodynamically unstable or severely symptomatic AV nodal blockade that is unresponsive to atropine and in whom temporary or transvenous pacing is not available or is ineffective, epinephrine (2 to 10 mcg/minute, titrate to response) and/or dopamine (2 to 10 mcg/kg/minute) maybe administered.14... 

The answer is a. (Hardman, p 224.) Epinephrine is the drug of choice to relieve the symptoms of an acute, systemic, immediate hypersensitivity reaction to an allergen (anaphylactic shock). Subcutaneous administration of a 1 1000 solution of epinephrine rapidly relieves itching and urticaria, and this may save the life of the patient when laryngeal edema and bronchospasm threaten suffocation and severe hypotension and cardiac arrhythmias become life-endangering. Norepinephrine, isoproterenol, and atropine are ineffective therapies Angioedema is responsive to antihis-... 

During cardiac sensitization tests, groups of two purebred male beagle dogs were exposed to concentrations at 0, 2,600, 5,200, 10,000, or 21,600 ppm (Mullin 1977) or concentrations of 9,000, 12,000, 13,000, 14,000, 15,000, 18,000, 19,000, or 20,000 ppm for 5 min (Hardy et al. 1989a). The vapor was administered to each restrained animal via a face mask. Prior to administration of intravenous epinephrine challenge, no evidence for cardiotoxicity was observed at these concentrations. (See Section 3.4 for discussion of cardiac sensitization tests.)... 

In an undated study, HCFC-141b was administered to male SpragueDawley rats at concentrations of 5,000, 10,000, or 20,000 ppm for 30 min (Eger, unpublished data). As exposure continued, bolus intravenous epinephrine, characterized as three times the dose that produced arrhythmias in the same rats anesthetized with halothane, was administered. The dose of epinephrine was defined as a maximum of 12 fig/kg. For this study, three or more premature ventricular contractions was considered an arrhythmic response (Table 4—5). Marked arrhythmias occurred at all concentrations. The author further compared the concentrations of halothane and HCFC-141b that produced arrhythmias with administration of various doses of exogenous epinephrine. The nominal chamber concentration for HCFC-141b did not differ from that of halothane. Furthermore, the arrhythmias were characterized as relatively mild and within acceptable limits for surgical anesthesia in humans. 

Adrenaline, when administered to humans at 20 ug. per min. levels, caused increases in pulmonary ventilation of 13 to 153 per cent. The percentage increases in oxygen consumption resulting from the same administration were 19 to 56 per cent.30 Noradrenaline at the same level caused increases in pulmonary ventilation of 39 to 70 per cent and changes in oxygen consumption from -23 percent up to +31 per cent. Funkenstein, et al.,31 have tabulated the differences in the pharmacological action of these two substances and have adduced good evidence that two different types of psychotic patients tend to secrete excessive amounts, respectively, of the two types of hormones. Those who appear to secrete excess epinephrine-like hormone are more likely, at better than the 0.01 level of probability, to be benefited by electric shock therapy. If there are, as indicated, wide... 

Anaphylaxis is a severe systemic allergic reaction, which can be fatal. Frequently the first symptom is itchy hives (welts) within minutes of exposure. Swelling of the larynx, with constriction of the air passage and a rapid drop in blood pressure quickly follow. Treatment includes immediate removal from exposure, administration of epinephrine, and strict avoidance of reexposure. 

Izquierdo I, Dalmaz C, Dias R, Godoy M. 1988. Memory facilitation by posttraining and pretest acth, epinephrine, and vasopressin administration two separate effects. Behav Neurosci 102(5) 803-806. 

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