Epinephrine: method of administration and indications

Epinephrine, better known as adrenaline, is a hormone and a neurotransmitter used in emergency situations where there is cardiac arrest.

this drug it has historically been used to treat bronchospasms and hypoglycemia. However, today we already have more specific drugs for these pathologies.

This substance increases the heart rate, constricts blood vessels, dilates the airways and participates in the fight or flight reaction of the nervous system in an emergency situation.

Speaking a little more technically, adrenaline is a catecholamine. It is a monoamine synthesized in the adrenal glands. and whose precursors are phenylalanine and tyrosine.

How is adrenaline given?

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epinephrine it is prepared as a solution to be given as an injection. Furthermore, it can be administered by different routes, depending on the needs:

  • intramuscular (I AM).
  • subcutaneous.
  • intravenous (IV).
  • intracardiac: only in extremely serious cases, and if the intravenous route is not feasible.

The last two types of administration it must be done in the hospitalunder cardiac monitoring and after dilution of the epinephrine solution in water for injections, which can be:

  • Sodium Chloride Solution 0.9%
  • Glucose 5%
  • 5% glucose in 0.9% sodium chloride solution.

Also, to avoid drug degradation due to light or oxidation, it is advisable to use the product immediately after diluting it. As for the dosage e the route of administrationboth parameters will depend on the diagnosis and the patient’s clinical situation.

However, in an emergency situation always a rapid route of administration should be usedas well as the intravenous.

Indications of epinephrine

As we have seen, epinephrine is a solution that it is collected in an ampoule of different concentrations. Among its medical applications, we can mention the following:

Heart attack

In addition to cardiac arrest, adrenaline is also given to treat other heart problems, such as arrhythmias resulting from reduced or absent cardiac output.

The action of epinephrine is to cause vasoconstriction and increase cardiac output. In other words, it contracts your heart and raises your heart rate to “revive” you.


Epinephrine is also used as a first-line treatment of anaphylaxis. This pathology is triggered when an allergic condition worsens and can even cause death due to extreme bronchoconstriction.

In these cases, this drug is suitable for its dilatory effects at the level of the respiratory tract.

Co-administration with local anesthetics

Epinephrine is added to a series of local anesthetics that are given as injections. The reason for this combination is that the vasoconstrictive effects of adrenaline allow to delay the absorption and, in this way, prolong the effect of the anesthetic drug.

Also, some of the negative effects of using local anesthetics with epinephrine could be due to the action of the latter, For example:

  • Apprehension.
  • Tachycardia.
  • Tremors.

What are the possible side effects?

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The use of this substance it is not free from possible negative effects and complications, especially when administered intravenously and intracardially. Possible adverse reactions to adrenaline are:

  • palpitations and tremors.
  • Tachycardia.
  • Cardiac arrhythmia.
  • Anxiety and hypertension.
  • Heachache.
  • Acute pulmonary edema.

Moreover, its use is contraindicated in a number of patients, such as those who are being treated with non-selective beta-blocker drugs.

This contraindication is due to the interaction of both drugs could lead to severe hypertensioneven going so far as to trigger a cerebral hemorrhage.

Although many people believe that the administration of epinephrine can cause heart failure due to its strong vasoconstrictor effect, this is not true.

Coronary arteries have only one type of receptor which, interacting with adrenaline, they trigger signals for vasodilationno vasoconstriction.


Epinephrine or adrenaline It is a drug administered by different routes, depending on the patient’s clinical situation, for the treatment of cardiac arrest and anaphylactic reactions, mainly.

There are formulations of epinephrine prepared for self-injection indicated in patients at risk of anaphylactic shock.

Like all medicines, this catecholamine is not without adverse effectswhich should be taken into consideration when administering the epinephrine solution.

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