Epinephrine

Major Uses

Epinephrine is a natural hormone that is also available as a drug to treat severe allergic reactions, asthma attacks, and heart problems. It is also used to increase blood pressure during procedures requiring anesthesia. It belongs to the class of medications called adrenergic agents and is used in dogs, cats, and other animals.

Epinephrine works by stimulating the heart and blood vessels, increasing blood pressure and heart rate, and increasing blood sugar levels. It also works against the effects of histamine, which is the substance released by the body that causes allergic reactions, and it relaxes smooth muscles in the lungs to improve breathing.

Common Precautions

Epineprine can cause numerous side effects when used as directed. These side effects include, but are not limited to, anxiety, tremors, excitability, vomiting, hypertension, and heart rhythm irregularities.

This drug is contraindicated in animals with narrow-angle glaucoma and should not be used in pregnant animals or those in labor. Epinephrine should not be administered to animals with certain heart irregularities, such as ventricular premature beats. Additionally, it should be used with great caution in animals experiencing shock.

Epinephrine is known to interact with a number of other medications, including antihistamines, propranolol and other beta blockers, alpha-blockers, alpha-2 agonists, anesthetics, digoxin, nitrates, levothyroxine, oxytocic agents, reserpine, phenothiazines, other sympathomimetic agents, certain diuretics, and tricyclic antidepressants.

Epinephrine should not be used in animals with a known allergy or hypersensitivity to the drug. Overdose is possible and may cause a sharp rise in blood pressure, brain hemorrhage, difficulty breathing, headache, abnormal heart rhythms, chest pain, breathing difficulty, vomiting, and pulmonary edema and dyspnea. Any known or suspected overdose warrants immediate veterinary attention, even if no symptoms of overdose have developed.

Storage

Epinephrine should be store at room temperature, in a tight fitting and light resistant container, away from extreme temperatures and out of the reach of animals and children. This medication should be protected from freezing. Epinephrine should not be used if it becomes discolored, contains particles, or is outdated.

Administration

Epinephrine is available in powdered form for inhalation and in 0.1 mg/ml and 1 mg/ml solutions.

In dogs and cats, the typical dose to treat severe allergic reactions or asthma is 0.005 to 0.01 mg per pound IV (0.01 to 0.02 mg/kg IV). For CPR, different doses have been used successfully and the dose may need adjusting or repeating. Doses may vary in different species, when the drug is given by a different route or concurrently with other medications, and with regards to a patient's age, breed, and health status. A veterinarian's dosing instructions and/or those printed on the medication label should be followed closely.

Epinephrine comes in two different concentrations: 1:1,000 and 1:10,000. It is extremely important not to confuse the concentrations when determining the proper dose. Questions or concerns about dosing should be handled by a veterinarian.