Top 300 Pharmacy Drug Cards

EPINEPHRINE: EpiPen, EpiPen Jr., Various

Class: Anaphylaxis Agent

Dosage Forms. Auto-Injector Kit: Delivers 0.3 mg epinephrine in 0.3 mL (1:1000 solution) or 0.15 mg epinephrine in 0.3 mL (1:2000 solution)

Common FDA Label Indication, Dosing, and Titration.

1. Emergency treatment of acute anaphylaxis due to allergic reactions: Children 15-30 kg, 0.15 mg (0.3 mL of a 1:2000 solution) IM or sq; Children >30 kg and Adults, 0.3 mg (0.3 mL of a 1:1000 solution) IM or sq; may be repeated if severe anaphylaxis persists

Off-Label Uses. None

MOA. Epinephrine treats severe allergic reactions to insect stings or bites, foods, drugs, and other allergens. It acts on both α- and β-adrenergic receptors. Through its action on α-adrenergic receptors, epinephrine lessens the vasodilation and increased vascular permeability that occurs during anaphylaxis, which can lead to loss of intravascular fluid volume and hypotension. Through its action on β-adrenergic receptors, epinephrine causes bronchial smooth muscle relaxation that helps alleviate bronchospasm, wheezing, and dyspnea that may occur during anaphylaxis. Epinephrine also alleviates pruritus, urticaria, and angioedema.

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Drug Characteristics: Epinephrine

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Medication Safety Issues: Epinephrine

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Drug Interactions: Epinephrine

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Adverse Reactions: Epinephrine

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Efficacy Monitoring Parameters. Resolution of symptoms of anaphylaxis (dyspnea, pruritus, urticaria, angioedema).

Toxicity Monitoring Parameters. Seek medical attention after emergency use and monitor for signs of cardiac toxicity and hypertension.

Key Patient Counseling Points. This drug may cause palpitations, tachyarrhythmia, pale skin, sweating, nausea, vomiting, asthenia, dizziness, headache, tremor, pain in eye, anxiety, apprehension, nervousness, or dyspnea. Instruct patient on proper administration technique. Immediately seek medical assistance, even if the patient feels better after epinephrine use.

Clinical Pearls. Epinephrine auto-injectors are intended for immediate self-administration as emergency supportive therapy only and are not a substitute for immediate medical care. Epinephrine is used for a wide variety of indications in the acute care setting, including in cardiac resuscitation attempts, and in combination with topical anesthetic as a vasodilator to reduce bleeding during suturing and other minor surgical procedures. Ophthalmic and inhaled dosage forms also available for other indications.