Epinephrine

Parenteral: with anaphylactic shock and other allergic reactions, hypoglycemia - s / c, less often - IM or / in slow; for adults - for 0.2–0.75 ml, for children - for 0.1–0.5 ml; Higher doses for adults with s / c administration: single - 1 ml, daily - 5 ml.

With an attack of bronchial asthma in adults - s / to 0.3–0.7 ml.

With cardiac arrest- intracardiac 1 ml.

Locally: to stop bleeding - swabs moistened with a solution of the drug; a few drops are added to the solution of local anesthetics immediately before administration.

For infusion, a device with a measuring device should be used to control the rate of infusion.
Infusions should be carried out in a large (preferably in the central) vein.
Intracardially injected during asystole, if other methods are not available, because there is a risk of cardiac tamponade and pneumothorax.
During the treatment period, it was recommended to determine the concentration of K + in the serum, the measurement of blood pressure, diuresis, IOC, ECG, central venous pressure, pulmonary artery pressure and wedging pressure in the pulmonary capillaries.
Excessive doses in myocardial infarction can increase ischemia by increasing myocardial oxygen demand.
Increases glycemia, and therefore, diabetes requires higher doses of insulin and sulfonylurea derivatives.
With endotracheal administration, absorption and final plasma concentration of the drug may be unpredictable.
Introduction of epinephrine in shock conditions does not replace blood transfusion, plasma, blood-substituting liquids and / or saline solutions.
Epinephrine is not advisable to use for a long time (narrowing of peripheral vessels, leading to the possible development of necrosis or gangrene).
There are no strictly controlled studies of the use of epinephrine in pregnant women. A statistically consistent relationship was established between the occurrence of deformities and inguinal hernia in children whose mothers used epinephrine during the first trimester or throughout pregnancy, it was also reported in one case about the occurrence of anoxia in the fetus after iv administration of the mother epinephrine. Epinephrine should not be used for pregnant women with blood pressure above 130/80 mm Hg. Experiments on animals have shown that when administered in doses 25 times higher than the recommended dose for humans, it causes a teratogenic effect.
When used during lactation, the risk and benefit should be assessed due to the high likelihood of side effects in the baby.
Application for the correction of hypotension during labor is not recommended, as it may delay the second stage of labor; when administered in large doses to weaken the contraction of the uterus, it can cause long-lasting atony of the uterus with bleeding.
Can be used in children with cardiac arrest, but care must be taken, since the dosing schedule requires 2 different concentrations of epinephrine.
When discontinuing treatment, the dose should be reduced gradually, since sudden withdrawal of therapy may lead to severe hypotension.
Easily destroyed by alkalis and oxidizing agents.
If the solution has acquired a pinkish or brown color or contains a precipitate, it cannot be injected. Unused parts should be destroyed.

Symptoms: excessive increase in blood pressure, tachycardia, alternating bradycardia, arrhythmias (including atrial and ventricular fibrillation), coldness and pallor of the skin, vomiting, headache, metabolic acidosis, myocardial infarction, brain cranial hemorrhage (especially in elderly patients) , pulmonary edema, death.

Treatment: stop the introduction, symptomatic therapy - to reduce blood pressure - alpha-blockers (phentolamine), with arrhythmias - beta-blockers (propranolol).