After administering an initial dose of epinephrine, the NIAID Expert Panel recommends transfer to an emergency facility for observation (4-6 hours or longer, depending on severity of the reaction) and possible further treatment.
The side effects of epinephrine present concerns as well, the authors wrote, including elevations in heart rate and blood pressure, arrhythmias and angina.
A patient treated for anaphylaxis remains under clinical observation for at least four hours after their last dose of adrenaline, or overnight as appropriate according to the Australasian Society of Clinical Immunology and Allergy Acute Management of Anaphylaxis guidelines.
Observe people for 6–12 hours from the onset of symptoms, depending on their response to treatment. In patients with reactions that are controlled promptly and easily, a shorter observation period may be considered provided that they receive appropriate post-reaction care prior to discharge.
Once epinephrine is administered, you should call 911 immediately and advise dispatchers that you have just used epinephrine for a suspected anaphylactic reaction. Make arrangements to be transported to an emergency room for additional treatment and for observation.
Call 911 or go to the emergency room immediately.
If you or your child do not feel better or get worse, you can inject another dose of EpiPen® or EpiPen Jr® 5 to 15 minutes after the first injection.
Seek immediate emergency medical help right away. Use EpiPen® (epinephrine injection, USP) 0.3 mg or EpiPen Jr® (epinephrine injection, USP) 0.15 mg Auto-Injectors right away when you have an allergic emergency (anaphylaxis). Get emergency medical help right away. You may need further medical attention.
Adjunctive agents — Agents that may be given as adjunctive therapies to epinephrine in the treatment of anaphylaxis include H1 antihistamines, H2 antihistamines, bronchodilators, and glucocorticoids.
Epinephrine is a relatively quick-acting medication. It begins to work immediately and wears off quickly. The side effects don't last very long. Most of the side effects should start to resolve within about 30 minutes and fully disappear within a few hours.
Epinephrine is a hormone made by the adrenal glands. It works within minutes to prevent progression and reverse the symptoms of anaphylaxis. People may wonder if they should administer epinephrine if they suspect — but aren't sure — that they are having an anaphylactic reaction.
After using an autoinjector to treat an allergic reaction or anaphylaxis, it is important to immediately seek emergency care. While epinephrine itself does not cause problems, an allergic reaction sometimes improves after treatment with epinephrine but then symptoms come back.
A second anaphylactic reaction, known as a biphasic reaction, can occur as long as 12 hours after the initial reaction. Call 911 and get to the nearest emergency facility at the first sign of anaphylaxis, even if you have already administered epinephrine , the drug used to treat severe allergic reactions.
Patients should be monitored for heart rate, cardiac rhythm, and blood pressure frequently if an IV drip is to be infused. Never interrupt an intravenous infusion of medication to administer an IVPB or other medication. Extravasation of epinephrine may cause tissue necrosis to skin.
Use minimal doses for minimal periods of time; “epinephrine-fastness” (a form of drug tolerance) can occur with prolonged use. Protect drug solutions from light, extreme heat, and freezing; do not use pink or brown solutions. Drug solutions should be clear and colorless (does not apply to suspension for injection).
Immediately after giving an injection, call 911 or get the person in anaphylactic shock to the emergency room. Don't wait, because the effects of the medicine can wear off and result in a second reaction.
The more common side effects include tachycardia, hypertension, headache, anxiety, apprehension, palpitations, diaphoresis, nausea, vomiting, weakness, and tremors. Careful monitoring of vital signs is crucial, especially in patients with polypharmacy.
The adrenal medulla releases epinephrine and norepinephrine (NE) into the bloodstream. Circulating epinephrine stimulates breathing, blood pressure, heart rate, and vasoconstriction and widens bronchioles in the lungs. These changes direct more blood to the muscles, heart, and other vital organs.
Epinephrine is an adrenergic agonist used to treat bronchospasm, anaphylactic reactions, bradycardia, cardiac arrest, and hypotension. Its toxicity is usually caused by iatrogenic errors. In overdose there is a typical rapid onset of agitation, hypertension, tachycardia, and dysrhythmias.
Epinephrine is the medication of choice for the initial treatment of anaphylaxis. If injected promptly, it is nearly always effective. Delayed injection can be associated with poor outcomes, including fatality.
EpiPen® may cause side effects. Side effects may include paleness, dizziness, weakness, shaking, headache, throbbing, restlessness, anxiety, tenseness, and fear.
Symptoms of an accidental injection are not usually so severe and may include: temporary numbness or tingling. pain and swelling at the injection site. elevated heart rate and/or heart palpations.
Remove the EpiPen®. Massage the injection site for 10 seconds. Remove the needle shield. Press against the outer mid-thigh (with or without clothing).
This medicine may cause pulmonary edema (fluid in the lungs). Check with your doctor right away if you have chest pain, difficult, fast, or noisy breathing, blue lips and fingernails, pale skin, increased sweating, coughing that sometimes produces a pink frothy sputum, or swelling in the legs and ankles.
Nursing Mothers
Ephedrine sulfate is excreted in breast milk. Use by nursing mothers is not recommended because of the higher than usual risk for infants.