Find information on thousands of medical conditions and prescription drugs.

Epinephrine

Epinephrine (INN), also epinephrin (both pronounced ep-i-NEF-rin), or adrenaline (BAN) is a hormone and a neurotransmitter. The Latin roots ad-+renes and the Greek roots epi-+nephros both literally mean "on/to the kidney" (referring to the adrenal gland, which secretes epinephrine). Epinephrine is sometimes shortened to epi in medical jargon. more...

Home
Diseases
Medicines
A
B
C
D
E
E-Base
Ecstasy (drug)
Edecrin
Edrophonium
Edrophonium chloride
Efavirenz
Effexor
Eflornithine
Elavil
Eldepryl
Elidel
Eligard
Elitek
Elixomin
Elixophyllin
Ellagic acid
Elmiron
Eloxatin
Elspar
Emtriva
Emylcamate
Enalapril
Enalaprilat
Enalaprilat
Endep
Enflurane
Enoxaparin sodium
Entacapone
Enulose
Epi-pen
Epinephrine
Epirubicin
Epitol
Epivir
Epogen
Eprosartan
Ergocalciferol
Ergoloid Mesylates
Ergotamine
Eryc
Eryped
Erythromycin
Esgic
Eskalith
Esmolol
Estazolam
Estazolam
Estrace
Estraderm
Estradiol
Estradiol
Estradiol valerate
Estring
Estrogel
Estrone
Estrostep
Ethacridine
Ethambutol
Ethchlorvynol
Ethosuximide
Ethotoin
Etiracetam
Etodolac
Etopophos
Etoposide
Etorphine
Evista
Exelon
Exemestane
Hexal Australia
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z

Epinephrine is a catecholamine, a sympathomimetic monoamine derived from the amino acids phenylalanine and tyrosine. Its ATC code is C01CA24.

William Bates reported in the New York Medical Journal in May 1886 the discovery of a substance produced by the suprarenal gland. Epinephrine was isolated and identified in 1895 by Napoleon Cybulski, Polish physiologist. The discovery was repeated in 1897 by John Jacob Abel. Jokichi Takamine discovered the same hormone in 1900, without knowing about the previous discovery; but, in later years, counterevidence is shown from the experiment note that Kaminaka leaves that the Takamine team is the discoverer of first adrenaline. It was first artificially synthesized in 1904 by Friedrich Stolz.

Actions in the body

Epinephrine plays a central role in the short-term stress reaction—the physiological response to threatening or exciting conditions (see fight-or-flight response). It is secreted by the adrenal medulla. When released into the bloodstream, epinephrine binds to multiple receptors and has numerous effects throughout the body. It increases heart rate and stroke volume, dilates the pupils, and constricts arterioles in the skin and gut while dilating arterioles in leg muscles. It elevates the blood sugar level by increasing hydrolysis of glycogen to glucose in the liver, and at the same time begins the breakdown of lipids in fat cells. Epinephrine has a suppressive effect on the adaptive immune system.

Epinephrine is used as a drug to promote peripheral vascular resistance via alpha-stimulated vasoconstriction in cardiac arrest and other cardiac disrhythmias resulting in diminished or absent cardiac output, such that blood is shunted to the body's core. This beneficial action comes with a significant negative consequence, increased cardiac irritability, which may lead to additional complications immediately following an otherwise successful resuscitation. Alternatives to this treatment include vasopressin, a powerful antidiuretic which also promotes peripheral vascular resistance leading to blood shunting via vasoconstriction, but without the attendant increase to myocardial irritability.

Because of its suppressive effect on the adaptive immune system, epinephrine is used to treat anaphylaxis and sepsis. Allergy patients undergoing immunotherapy can get an epinephrine rinse before the allergen extract is administered, thus reducing the immune response to the adminsitered allergen. It is also used as a bronchodilator for asthma if specific beta-2-adrenergic agonists are unavailable or ineffective. Adverse reactions to epinephrine include palpitations, tachycardia, anxiety, headache, tremor, hypertension, and acute pulmonary edema.

Read more at Wikipedia.org


[List your site here Free!]


Vasopressin vs. epinephrine for patients in cardiac arrest
From American Family Physician, 8/1/04 by Bill Zepf

Concerns have been raised about ventricular arrhythmias and myocardial dysfunction following epinephrine treatment in patients with cardiac arrest, and laboratory studies of vasopressin have demonstrated some beneficial effects in cardiopulmonary resuscitation CPR). Wenzel and colleagues report on a study for the European Resuscitation Council comparing vasopressin and epinephrine in patients with cardiac arrest.

This multinational trial initially screened 5,967 adult patients with out-of-hospital cardiac arrest. After excluding patients who were successfully defibrillated without need for a vasopressor and patients with terminal illness, lack of intravenous access, or several other clinical variables, 1,186 patients remained in whom vasopressin and epinephrine could be compared. Patients needing vasopressor drugs during CPR were randomly assigned to receive 1 mg of epinephrine or 40 IU of vasopressin; the dose was repeated in three minutes if spontaneous circulation had not been restored. After two doses of the assigned study drug, an injection of epinephrine could be given at the discretion of the resuscitating physician (the median dose given was 5 mg).

There were no significant differences between the medications in overall rates of spontaneous circulation recovery (24.6 percent versus 28.0 percent), survival to hospital discharge (9.9 percent versus 9.9 percent), or good neurologic outcome in survivors 32.6 percent versus 34.8 percent). Patients with a witnessed cardiac arrest and those in whom CPR was begun within 10 minutes of arrest had improved chances of survival to hospital admission, as did patients who received amiodarone or fibrinolysis in the resuscitation regimen. The only subgroup with a significant difference in outcome between vasopressin and epinephrine represented patients with asystole as the presenting rhythm (44.5 percent of arrest patients overall). More patients with asystole who were treated with vasopressin survived to hospital discharge than those assigned to receive epinephrine. The discretionary dose of epinephrine helped improve outcomes in patients who were randomized to vasopressin but not in patients who had already received epinephrine.

The authors conclude that vasopressin and epinephrine have similar efficacy in patients with out-of-hospital cardiac arrest, and that vasopressin is advantageous in the subgroup of patients with asystole as a presenting rhythm.

REFERENCE

(1.) McIntyre KM. Vasopressin in asystolic cardiac arrest [Editorial]. N Engl J Med January 8, 2003;350:179-81.

Wenzel V, et al. A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation. N Engl J Med January 8, 2003;350:105-13.

EDITOR'S NOTE: The authors mention in their discussion of the study that the outcome data did not confirm earlier studies that showed an advantage to use of vasopressin in cardiac arrest patients with ventricular fibrillation and pulseless electrical activity. An accompanying editorial (1) by McIntyre speculates on the reasons that the survival advantage of vasopressin may be limited to patients with asystole. Epinephrine and other catecholamines appear to be less effective vasopressors in the hypoxic, acidotic cardiac environment of asystole. He notes that the increased myocardial oxygen consumption occurring with epinephrine may have harmful effects in patients with asystolic cardiac arrest.

COPYRIGHT 2004 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group

Return to Epinephrine
Home Contact Resources Exchange Links ebay