What May Interact With This Medicine
Do not take this medicine with any of the following medications:
- MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
- medicines for colds and breathing difficulties
- medicines for hay fever and other allergies
- stimulant medicines for attention disorders, weight loss, or to stay awake
This medicine may also interact with the following medications:
- medicines for depression, anxiety, or psychotic disturbances
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
What Are Warnings And Precautions For Epinephrine Racemic
This medication contains epinephrine racemic. Do not take AsthmaNefrin or S2 if you are allergic to epinephrine racemic or any ingredients contained in this drug.
Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.
- Coadministration with monoamine oxidase inhibitors , or within 2 weeks after discontinuing an MAOI
Effects of Drug Abuse
How Should This Medicine Be Used
Epinephrine oral inhalation comes as an aerosol to inhale by mouth. It is used as needed to control your asthma symptoms. Follow the directions on the product label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use epinephrine oral inhalation exactly as directed. Do not use more or less of it or use it more often than directed.
Epinephrine oral inhalation is available without a prescription . This medication should only be used if a doctor has told you that you have asthma.
If your symptoms do not improve within 20 minutes of use, if your asthma becomes worse, if you need more than 8 inhalations in a 24-hour period, or if you have more than 2 asthma attacks in a week, see a doctor right away. These may be signs that your asthma is getting worse and that you need a different treatment.
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Epinephrine Saves Lives For Anaphylaxis And Severe Asthma Attacks
Several of our American readers responded quickly to an article in Mondays British Daily Mail to news that a 14-year-old girl, Naishel Kelly, died very soon after reporting difficulty breathing. She was taken to the school nurses office where she collapsed. Paramedics rushed her to the Royal Sussex County Hospital but she was pronounced dead on arrival. There were suggestions that Naishel, who had a nut allergy, had eaten a chocolate brownie for lunch. However, a police spokesperson said this wasnt a factor in her death.
I have several thoughts reading this. First, my sympathies to the family for their terrible loss.
Second, I wonder at the police spokespersons instant dismissal of nut allergy as a factor. I suggest he or she wait for the autopsy.
Third, and more important that the police pronouncement, it points to the overlap of asthma and food allergy . The two are often discussed as if there were no connection. Theres a reason why we must look at both together. The best research shows that fatal food allergy anaphylaxis most often results when epinephrine isnt available or when an individual also has poorly controlled asthma. As in many other aspects of allergic medicine and medicine in general, there are very few discrete categories. Epinephrine is the best emergency treatment for acute anaphylaxis and for severe asthma attacks.
To read my thoughts about Allergic Injury And Death At School: What Will It Take To Protect Our Children, .
Where Should I Keep My Medicine
Keep out of the reach of children.
Store at room temperature between 15 and 30 degrees C . Do not freeze. Protect from light. Throw away any unused medicine after the expiration date.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.
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How Should I Use Epinephrine Inhalation
Use exactly as directed on the label, or as prescribed by your doctor.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Before using this medicine for the first time, shake the inhaler and prime it with 4 test sprays into the air, away from your face.
Also shake the inhaler just before each use and prime it with 1 spray.
Each dose is 1 to 2 inhalations. After the first inhalation, wait 1 minute. Then use a second inhalation if your symptoms have not improved.
Wait at least 4 hours between doses. Do not use more than 8 inhalations in 24 hours.
Seek medical attention if your breathing problems do not improve after 20 minutes, or if they get worse quickly.
Tell your doctor if you have more than 2 asthma attacks in 1 week.
Do not share this medicine with another person, even if they have the same symptoms you have.
Store at room temperature away from moisture and heat. Keep away from open flame or high heat. The canister may explode if it gets too hot. Do not puncture or burn an empty inhaler canister.
Wash the inhaler after each day of use by running water through the mouthpiece for 30 seconds.
Intramuscular Epinephrine As An Adjunctive Treatment For Severe Pediatric Asthma Exacerbation
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|First Posted : October 12, 2012Results First Posted : July 6, 2021Last Update Posted : July 6, 2021|
- Study Details
Project Aim: To determine if intramuscular epinephrine is an effective adjunct to inhaled bronchodilators for children with severe asthma exacerbation.
Hypothesis: IM epinephrine is an efficacious adjunct to inhaled bronchodilators for children with severe asthma exacerbation.
Intervention: Subjects will be randomly assigned to receive a weight based dose of IM epinephrine 1:1000 or no adjunctive medication. The dose will be 0.2 mg for subjects 20-30 kg and 0.3 mg for subjects greater than 30 kg. This will be injected intramuscularly by an ED nurse into the anterior thigh muscles of the subject using a 1 ml syringe and a 23 gauge one inch needle.
|Drug: IM epinephrine 1:1000Other: No intervention||Phase 4|
|Study Type :|
|Intramuscular Epinephrine as an Adjunctive Treatment for Severe Pediatric Asthma Exacerbation|
|Study Start Date :|
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Different Types Of Asthma Medications
Many first-line controller and rescue medications are administered through asthma inhalers. Some of these inhalers are called metered-dose inhalers in which the inhaler itself propels the medication into the lungs. Other inhalers are activated by patients taking a breath, and these are called dry powder inhalers or breath-actuated inhalers. Different types of inhalers may work better for different individuals, but both types of inhalers are effective for asthma symptom control if used correctly.
Nebulizers are machines that allow asthma medications to be delivered in an aerosolized form, and the medications are then inhaled through a mouthpiece or mask. Nebulizers are often used for children who are unable to perform the proper technique required for inhalers. Some asthma medications are also available as pills. There are currently two injectable medications for asthma , and these are administered in a health-care setting only. There is also an intravenous medication for asthma . Within the near future, there will likely be additional asthma medications that can be administered either by injection or intravenously.
The cause of asthma is unknown. Physicians know more about the abnormal conditions that occur in asthma. These conditions include:
How To Use Epinephrine Aerosol
Shake the canister well before each inhalation. Follow all directions on the product package. If you have any questions, ask your doctor or pharmacist. If you take other asthma drugs by mouth or with inhaling devices, ask your doctor about how to correctly take this medication with your other asthma medicines.
Use this medication exactly as directed in the product package. Inhale by mouth as needed. Take the cap off the mouthpiece. Place the mouthpiece near your mouth and exhale. Place the mouthpiece fully into your mouth and press the inhaler as you breathe in deeply. Hold your breath for as long as comfortable to allow the drug to be absorbed. If more than one inhalation is needed, wait at least 1 full minute between inhalations. Do not use again for at least 4 hours. If your breathing does not get better within 20 minutes after using this medication, or if your breathing gets worse, get medical help right away.
Rinse your mouth after using this medication to help prevent dryness and throat irritation. Do not use more of this medication or use it more often than recommended by the product package or your doctor.
Clean the mouthpiece after each day of use as directed. The mouthpiece should also be cleaned if it is clogged or not working properly.
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Mythbuster Can Antihistamines And Asthma Medications Be Used Instead Of Epinephrine To Treat Anaphylaxis
FACT: Antihistamines and asthma medications should not be used instead of epinephrine to treat anaphylaxis.
While these drugs will do no harm when given as additional or secondary medication, they have NOT been proven to stop an anaphylactic reaction. Epinephrine is the only drug that can reverse symptoms of anaphylaxis and is considered life-saving medication. Canadian allergists advise that an epinephrine auto-injector is the first line of treatment for anaphylaxis and should be used before asthma inhalers, antihistamines, or any other medications. The main benefit of antihistamines is in treating hives or skin symptoms.
Bottom line: Use your epinephrine auto-injector to treat anaphylaxis, and dont delay.
Learn more about the importance of epinephrine from Dr. Moshe Ben-Shoshan and Beatrice Povolo, our Director, Advocacy & Media Relations, with these short videos.
Help us educate your communities and share this mythbuster with them! Find more mythbusters at foodallergycanada.ca/mythbusters.
How Should I Use Epinephrine Injection
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Epinephrine is injected into the skin or muscle of your outer thigh. In an emergency, this injection can be given through your clothing.
This medicine may come with a “trainer pen.” The trainer pen contains no medicine and no needle. It is only for non-emergency use to practice giving yourself an epinephrine injection.
Read and follow all Instructions for Use. Ask your doctor or pharmacist if you need help.
Do not give this medicine to a child without medical advice.
The auto-injector device is a disposable single-use system. Use an auto-injector only one time.
Do not try to reinsert an auto-injector a second time. If the needle is bent from the first use, it may cause serious injury to your skin.
Seek emergency medical attention after any use of epinephrine. The effects of epinephrine may wear off after 10 or 20 minutes. You will need to receive further treatment and observation.
Also seek emergency medical attention if you accidentally inject yourself while giving epinephrine to another person.
Store at room temperature away from moisture, heat, and light. Do not refrigerate or freeze this medicine, and do not store it in a car. Do not use epinephrine injection if it has changed colors or has particles in it.
Do not use if the expiration date on the label has passed. Call your pharmacist for a new prescription.
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Conditions Affected By Epinephrine
The following health conditions are linked to epinephrine levels:
Addison’s disease is a severe or total deficiency of the hormones made by the adrenal glands, including epinephrine, cortisol, and aldosterone.
Adrenal tumors, some called pheochromocytoma, can cause too much adrenal hormones to be produced. In the case of pheochromocytoma, the hormones produced are epinephrine and noradrenaline.
This over-secretion of epinephrine can lead to a dangerous and severe elevation in blood pressure.
In different types of adrenal tumors, other hormones are over-produced, including cortisol, aldosterone, and androgens.
What Is Epinephrine Injection
Epinephrine injection is used to treat severe allergic reactions to insect stings or bites, foods, drugs, and other allergens.
Epinephrine auto-injectors may be kept on hand for self-injection by a person with a history of severe allergic reaction.
Epinephrine is also used to treat exercise-induced anaphylaxis, or to treat low blood pressure that is caused by septic shock.
Epinephrine injection may also be used for purposes not listed in this medication guide.
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How Effective Is Epinephrine For Asthma
Asthma is a respiratory disorder characterized by inflammation in the respiratory system, and many types of medications are used to treat it. Pharmaceutical epinephrine, a synthetic version of a naturally-occurring compound, is a medication that has been used for decades as a remedy for this condition. Taking epinephrine for asthma remains one of the most effective ways to control sudden attacks that cause breathing problems. The potency of this medication, as well as the potential for side effects, mean it is not used as often as other types of asthma therapies.
Individuals do not usually take this medication as a daily maintenance drug, but instead may take epinephrine for asthma attacks. It is administered by subcutaneous injection, or an injection just below the skin. Injection allows for the drug to rapidly take effect, making it useful in situations where an asthma attack is causing severe breathing problems. Vaporized medication is the alternative for asthma attacks, and in extreme cases, individuals undergoing an attack may not be able to keep their mask on to inhale the medication. Epinephrine, therefore, remains a useful treatment for asthma because it can be given to a person regardless of their condition, or how well they manage their condition.
What Is Primatene Mist
Early in the 20th century, scientists discovered that an inhaled solution of epinephrine could be used to provide temporary relief from some of the symptoms of asthma. And by the middle part of the century, metered dose inhalers had come into being. For more than 50 years, the branded form of epinephrine, called Primatene Mist, was sold over the counter.1 These historical inhalers used substances called chlorofluorocarbons to propel the mist into your airways. Millions of asthmatics grew used to this inexpensive asthma relief.
Then, in 2011, new regulations aimed at protecting the ozone layer went into effect prohibiting the use of CFCs. So Primatene Mist was taken off the market, as were many types of prescription quick-relief inhalers. New prescription inhalers were quickly rolled out that used the safer hydrofluoroalkanes as propellants. Unfortunately, no over-the-counter replacements have been available since then.2
But, in late 2018, the Food and Drug Administration approved a new HFA version of Primatene Mist. It has become widely available this year.2
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Epinephrine And Its Use In Acute Life
Jaswin Bhullar Friday, October 7, 2011
Epinephrine is commonly used by paramedics in a range of clinical scenarios. Its role in cardiac arrest scenarios is well established, but the indications for use in acute severe or life-threatening asthma are less well defined. This article reviews the evidence for the use of epinephrine in acute severe asthma and uses a case study to highlight some of the potential side-effects that clinicians need to be aware of.
Epinephrine is a catecholamine produced by the adrenal glands and has actions on nearly all cell types in its role as a hormone and neurotransmitter. Epinephrine acts upon p1 and p2 adrenergic receptors. It produces the fight or flight response namely, increased cardiac output and bronchodilation .
In lower doses, the p receptors are stimulated preferentially resulting in smooth muscle relaxation, peripheral vasodilatation and hypotension. Higher doses result in stimulation of peripheral alpha-receptors resulting in an increase in peripheral vascular resistance and elevation of blood pressure .
It was first artificially synthesized in 1904 by Friedrich Stolz and since that time has become a key tool in managing critically unwell patients. Its role in a diverse range of conditions is well documented, from respiratory problems such as croup and anaphylaxis to cardiac arrest victims .
Why Is This Medication Prescribed
Epinephrine oral inhalation is used to relieve symptoms of asthma that occur from time to time, including wheezing, chest tightness, and shortness of breath in adults and children 12 years of age and older. Epinephrine oral inhalation is in a class of medications called alpha- and beta-adrenergic agonists . It works by relaxing and opening air passages to the lungs to make breathing easier.
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What Happens If I Overdose
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include numbness or weakness, severe headache, blurred vision, pounding in your neck or ears, sweating, chills, chest pain, fast or slow heartbeats, severe shortness of breath, or cough with foamy mucus.