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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...

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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.

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Lidocaine and Epinephrine solution for iontophoretic induction of analgesia approved
From Journal of Drugs in Dermatology, 1/1/05

Empi, Inc., has announced FDA approval of a Lidocaine HCl 2% and Epinephrine 1:100,000 solution for use with the company's Action Patch Iontophoresis System for the iontophoretic induction of local analgesia during superficial dermatologic procedures such as venupuncture, shave removals, and punch biopsies. The iontophoretic system delivers an 80mAmin dose in about 3 hours, using 10.5 volts of battery power to allow optimal transfer of drug solution to the skin. The system features pH buffering and a light that automatically turns off when drug transfer is complete.

COPYRIGHT 2005 Journal of Drugs in Dermatology
COPYRIGHT 2005 Gale Group

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