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epinephrine racemic (OTC)Brand and Other Names:AsthmaNefrin, S2

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

solution for nebulization

  • 11.25mg/0.5mL (2.25% as 1.125% dextro-epinephrine and 1.125% levo-epinephrine)
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Bronchial Asthma

Indicated for temporary relieve of symptoms associated with bronchial asthma (eg, shortness of breath, chest tightening, wheezing)

S2: 0.5 mL of 2.25% solution diluted in 3 mL NS via jet nebulizer q3-4hr PRN

Asthmanefrin: 1-3 inhalations of 0.5 mL of 2.25% solution via EZ Breathe Atomizer

Dosage Forms & Strengths

solution for nebulization

  • 11.25mg/0.5mL  (2.25% as 1.125% dextro-epinephrine and 1.125% levo-epinephrine)
more...

Bronchial Asthma

Indicated for temporary relieve of symptoms associated with bronchial asthma (eg, shortness of breath, chest tightening, wheezing)

Asthmanefrin

  • <4 years: Safety and efficacy not established
  • ≥4 years: 1-3 inhalations of 0.5 mL of 2.25% solution via EZ Breathe Atomizer

S2

  • <4 years old: 0.05 mL/kg via jet nebulizer (diluted to 3 mL with NS) over 15 minutes; no more than q12hr; not to exceed 0.5 mL/dose
  • ≥4 years old: 0.5 mL of 2.25% solution via jet nebulizer (diluted to 3 mL with NS) over 15 minutes q3-4 hr PRN

Use low end of dosing range for younger infants

Should observe rapid response, can be repeated q2hr in older children but monitor HR with repeated dosing

Croup

<4 years: 0.05 mL/kg of 2.25% solution (S2) via jet nebulizer (diluted to 3 mL with NS) over 15 minutes q3-4 hr PRN; not to exceed 0.5 mL/dose

≥4 years old: 0.5 mL of 2.25% solution (S2) via jet nebulizer (diluted to 3 mL with NS) over 15 minutes q3-4 hr PRN

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Interactions

Interaction Checker

epinephrine racemic and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Tachycardia

            Arrhythmias

            Headache

            Nausea

            Sweating

            Tremor

            Restlessness

            Rebound airway edema may occur

            Angina

            Autonomic hyperreflexia

            Cardiac dysrhythmia

            Ventricular fibrillation

            Cerebral hemorrhage

            Pulmonary edema

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            Warnings

            Contraindications

            Epiglottitis

            Coadministration with MAOIs, or within 2 weeks after discontinuing an MAOI

            Cautions

            For oral inhalation only

            Caution with heart disease, hypertension, thyroid disease, diabetes, or urinary retention caused by prostate enlargement

            Instruct patient to seek immediate medical attention if symptoms not relieved within 20 minutes or become worse following administration

            Do not use if product is brown in color or cloudy

            Do not use if product is pinkish or darker than slightly yellow, or if it contains a precipitate

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Elicits agonistic action on alpha, beta-2, and beta-2 receptors resulting in bronchial smooth muscle relaxation, cardiac stimulation, vasodilation in skeletal muscle, and stimulation of glycogenolysis in the liver

            Pharmacokinetics

            Onset: 1-5 min

            Duration: 1-3 hr

            Metabolism: liver

            Metabolites: metanephrine & 3-methoxy-4-hydroxymandelic acid (vanillylmandelic acid, VMA)

            Excretion: unknown

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