Epinephrine Racemic
Mechanism :
Racepinephrine inhalation solution is an alpha- and beta-receptor stimulant. It works by widening the airway, which makes it easier to breathe.
It is a racemic preparation of Epinephrine available as a respiratory solution, which is given as a nebulisation in post-extubated patients to prevent stridor.
Indication :
- Wheezing associated with asthma
- Post-extubated patients to prevent stridor
- Croup
Contraindications :
Hypersensitivity, Epiglottitis, Coadministration with MAOIs, or within 2 weeks after discontinuing an MAOI.
For oral inhalation only.
Caution with heart disease, hypertension, thyroid disease, diabetes, or urinary retention caused by prostate enlargement.
Dosing :
Bronchial Asthma:
<4 years:
0.05 ml/kg/dose diluted with 3 ml normal saline given as a nebulization over 15 minutes every 12 hourly. Max dose: 0.5 ml.
>4 years:
0.05 ml/kg/dose of 2.25% solution diluted with 3 ml normal saline given as a nebulization over 15 minutes every 3-4 hours as per requirement. Max dose: 0.5 ml.
Croup:
0.05 ml/kg/dose of solution diluted with 3 ml normal saline given as a nebulization over 15 minutes every 3-4 hours as per requirement. Max dose: 0.5 ml.
Adverse Effect :
Tachycardia, hypertension, peripheral coronary arterial vasodilation (low dose), vasoconstriction (high dose), arrhythmias, nausea and vomiting, disorientation, agitation, aggressive behaviour, impaired memory, hallucinations, psychosis, hemorrhage, hemiplegia, subarachnoid hemorrhage, anginal pain, throbbing headache, tremor, weakness, flushing, dizziness, pallor and respiratory difficulty.
Interaction :
Adrenergic Agents: Concurrent use with other adrenergic agents will have additive adrenergic side effects.
MAO inhibitors: Use with MAO inhibitors may lead to hypertensive crisis.
Beta blockers: May negate therapeutic effect.
Tricyclic antidepressants: Enhance pressor response to epinephrine.
Hepatic Dose :
No dosage adjustments are recommended.