EPINEPHRINE

Epinephrine is rapidly inactivated in the body, and treatment is primarily supportive. If necessary, pressor effects may be counteracted by rapidly acting vasodilators or alpha-adrenergic blocking drugs. If prolonged hypotension follows such measures, it may be necessary to administer another pressor drug, such as levarterenol.

Overdosage of epinephrine may produce extremely elevated arterial pressure, which may result in cerebrovascular hemorrhage, particularly in elderly patients.

If an epinephrine overdose induces pulmonary edema that interferes with respiration, treatment consists of a rapidly acting alpha-adrenergic blocking drug such as phentolamine and/or intermittent positive-pressure respiration.

Epinephrine overdosage can also cause transient bradycardia followed by tachycardia, and these may be accompanied by potentially fatal cardiac arrhythmias. Ventricular premature contractions may appear within one minute after injection and may be followed by multilocal ventricular tachycardia (prefibrillation rhythm). Subsidence of the ventricular effects may be followed by atrial tachycardia and occasionally by atrioventricular block. Treatment of arrhythmias consists of administration of beta-adrenergic blocking drug such as propranolol. Overdosage sometimes also results in extreme pallor and coldness of the skin, metabolic acidosis, and kidney failure. Suitable corrective measures must be taken.

CHLO-AMINE®

Overdose symptoms may be sedation, apnea, cardiovascular collapse to stimulation, insomnia, hallucinations, tremors or convulsions. Also there may be dizziness, tinnitus, ataxia, blurred vision, hypotension, dry mouth, flushing, and abdominal symptoms.

Treatment - The patient should be induced to vomit, preferably with ipecac syrup, and large amounts of water. Prevent aspiration of vomitus. Gastric lavage may be necessary using activated charcoal and saline. Hyperosmotic cathartics such as Milk of Magnesia may hasten elimination of residual cling. Vasopressors can be used to correct hypotension. Diazepam may be used to control seizures. Hyperpyrexia can be treated with cool sponges or a hypothermic blanket.

EPINEPHRINE

Epinephrine must not be given intra-arterially as marked vasoconstriction may result in gangrene. This unit is not intended for intravenous use. Further dilution would be necessary and is not practical with this emergency syringe.

Epinephrine Injection, USP, (1:1000) must not be used if there is hypersensitivity to any of the components. Epinephrine is contraindicated in narrow-angle glaucoma; cardiogenic, traumatic, or hemorrhagic shock; cardiac dilation; cerebral arteriosclerosis; and organic brain damage.

Epinephrine should not be used to counteract circulatory collapse or hypotension due to phenothiazines, since such agents may reverse the pressor effect of epinephrine, leading to a further lowering of blood pressure.

Epinephrine should not be administered concomitantly with other sympathomimetic agents, since the effects are additive and may be detrimental to the patient.

CHLO-AMINE®

No known contraindications.

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