(4) When applied locally to the eyes, occasionally a mydriatic effect
(dilation of the pupils) will occur.
b. Therapeutic Uses. Epinephrine is used to control hemorrhage from minor
cuts, but it is not effective when a vein or artery is involved. It relieves nasal
congestion by vasoconstriction for a short duration. It is used in conjunction with local
anesthetics to prolong their action and to lessen the possibility of hemorrhage.
Epinephrine is valuable in treating bronchial asthma, as an injection or by inhalation. It
is also used frequently to relieve such allergic disorders as urticaria, serum reactions,
and anaphylactic shock, for which epinephrine is the most often used drug. Certain
heart failures can be corrected by injecting epinephrine directly into the heart.
However, epinephrine is not of much value in the treatment of hemorrhagic,
cardiogenic, or traumatic shock or circulatory collapse, and it may be harmful.
c. Administration. For the treatment of anaphylactic shock, epinephrine may
be given IM as 1.0 ml of the 1:1000 solution. In general, the solutions for injection may
be given SC, IM, or IV. However, the suspension in oil is preferably administered IM,
though it may be given subcutaneously.
d. Untoward Effects. Some undesirable effects of this drug include insomnia,
nervousness, anxiety, tremors, headache, and rapid heartbeat.
e. Cautions and Contraindications. Extreme care should be used to ensure
that a dosage of epinephrine prepared for a client is in the appropriate concentration
and amount. Because of its powerful vasopressor action, overdosage is especially
dangerous in a client with an open wound, since fresh hemorrhage may result when the
blood pressure is markedly elevated. Epinephrine is contraindicated for persons with
heart disorders. An epinephrine preparation should be clear and colorless. If the
solution is colored or has a sediment, it should not be used. All epinephrine
preparations should be kept from freezing, and the package should be checked for the
f. How Supplied. Epinephrine is available in strengths of 1:1000 for injection
(in 1 ml cartridge-needle units and 1 ml ampules), 1:2600 for injection (in 1 ml
ampules), and a 1:500 suspension in oil for intramuscular injection (in 1 ml ampules). It
is also available in 1 percent and 2 percent ophthalmic solutions.
a. Action and Uses. Ephedrine occurs naturally in various plants. This drug is
very similar to epinephrine in its action. The administration of ephedrine results in
vasoconstriction and stimulation of the heart that produces an elevation of blood
pressure. Although this effect upon the blood pressure is not as great as that produced
by the administration of epinephrine, it lasts seven to 10 times as long. The use of
ephedrine produces relaxation of bronchial muscles that is less prominent than that
obtained with epinephrine, but is sustained for a much longer time. This action of