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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Adrenergics in combination with corticosteroids or other drugs, excl. anticholinergics
epinephrine and other drugs for obstructive airway diseases
R03AK01
Forms & Strengths
- Inhalation aerosol (metered-dose inhaler)
- Solution for nebulization
Adult Dosing
- MDI: 1-2 inhalations (typically containing 0.16-0.22 mg epinephrine base per inhalation) as needed for acute bronchospasm; wait at least 1-3 minutes between inhalations
- Nebulization: 0.25-0.75 mL of 2.25% racemic epinephrine solution diluted in 2 mL normal saline as needed
Pediatric Dosing
- Safety and efficacy in pediatric patients under 4 years not well established
- Children >= 4 years (MDI): 1-2 inhalations as needed for acute symptoms, under adult supervision
- Children (Nebulization): 0.25-0.5 mL of 2.25% racemic epinephrine solution diluted in 2 mL normal saline
Indications
- Temporary relief of shortness of breath, tightness in the chest, and wheezing due to bronchial asthma
Mechanism of Action
- Non-selective alpha and beta adrenergic agonist
- Stimulation of beta-2 adrenergic receptors on bronchial smooth muscle produces relaxation and bronchodilation
- Decreases bronchial secretions and inhibits histamine release, reducing mucosal congestion and edema
Contraindications
- Hypersensitivity to sympathomimetic amines
- Narrow-angle glaucoma
- Anesthesia with halogenated hydrocarbons (sensitizes myocardium to arrhythmias)
- Concurrent use with non-selective monoamine oxidase inhibitors (MAOIs)
Adverse Reactions
- Tachycardia, palpitations, and arrhythmias
- Elevated blood pressure or hypertension
- Tremors, nervousness, and anxiety
- Headache, dizziness, and nausea
- Rebound bronchospasm with excessive use
Drug Interactions
- Beta-blockers antagonize the bronchodilating effects and may provoke severe bronchospasm
- MAOIs and tricyclic antidepressants potentiate vascular effects, risking severe hypertension
- Other sympathomimetic agents result in additive toxicity and increased cardiovascular adverse effects
- Cardiac glycosides or potassium-depleting diuretics increase the risk of cardiac arrhythmias
Curated Content: Needs Vetting Before Put to Clinical Use