Epinephrine (medication)

Epinephrine (medication) is a pharmaceutical drug used to treat a number of conditions including: anaphylaxis, cardiac arrest, and superficial bleeding. It has been in medical use since the early 1900s. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.

Epinephrine-ampule

Medical uses

Epinephrine is used to treat a number of conditions including: anaphylaxis, cardiac arrest, and superficial bleeding. Inhaled epinephrine may be used to improve the symptoms of croup. It may also be used for asthma when other treatments are not effective. It is given intravenously, by injection into a muscle, by inhalation, or by injection just under the skin.

Anaphylaxis

Epinephrine is the treatment of choice for anaphylaxis and is recommended for any severe systemic reaction. It is given intramuscularly as soon as possible. More doses may be given every 5 to 15 minutes as needed.

Cardiac arrest

While typically used for people in cardiac arrest, epinephrine appears to worsen outcomes in those with out of hospital cardiac arrest. This appears to be true even in those with a witnessed cardiac arrest.

Bleeding

Epinephrine is used to treat minor bleeding from superficial wounds.

Side effects

Common side effects include shakiness, anxiety, and sweating. A fast heart rate and high blood pressure may occur. Occasionally it may result in an abnormal heart rhythm. While the safety of its use during pregnancy and breastfeeding is unclear, the benefits to the mother must be taken into account.

Pharmacology

Epinephrine acts by binding to a variety of adrenergic receptors. Epinephrine is a nonselective agonist of all adrenergic receptors, including the major subtypes α1, α2, β1, β2, and β3. Epinephrine's binding to these receptors triggers a number of metabolic changes.

History

Epinephrine was first isolated by Jokichi Takamine, a Japanese chemist, in the United States in 1901. It was first artificially synthesized by Friedrich Stolz and Henry Drysdale Dakin, independently, in 1904.

Society and culture

It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication. The wholesale cost in the developing world is between 0.10 and 0.95 USD per dose. In the United States it costs about 0.60 USD per dose.

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