Epinephrine: Uses, Dosage and Side Effects

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Epinephrine (Adrenaline): Uses, Dosage and Side Effects

Epinephrine: Uses, Dosage And Side Effects In Dogs, Cats, Horses And All Animals

Overview

Epinephrine (adrenaline) exerts its effects via alpha-1, alpha-2, beta-1, and beta-2 adrenergic receptors. The duration of action is short, typically 2โ€“5 minutes. Its effects vary depending on the dose:

    • Low-dose infusions: Primarily exhibit beta-adrenergic effects, such as increased cardiac output, myocardial oxygen consumption, decreased arrhythmia threshold, peripheral vasodilation, and a reduction in diastolic blood pressure.
    • High-dose infusions: Alpha-1 effects dominate, resulting in an increase in systemic vascular resistance and diversion of blood to central organs. This can improve cardiac output and blood flow.
    • Respiratory Effects: Includes bronchodilation and an increase in pulmonary vascular resistance. Renal blood flow is moderately decreased.

Uses of Epinephrine in Dogs, Cats, Horses and All Animals

  • Status Asthmaticus: Used in emergencies to alleviate severe asthma symptoms.
  • Cardiac Resuscitation: Employed during cardiac arrest to stimulate the heart.
  • Anaphylactoid Reactions: Administered to mitigate the effects of histamine release in severe allergic reactions.
  • Ophthalmic Use: The ophthalmic preparation is used in the management of open-angle glaucoma to decrease intraocular pressure.
  • Other Animals:
    1. Horses: Used in emergencies such as anaphylaxis, cardiac arrest, and acute asthma.
    2. Livestock (e.g., cattle, sheep): Sometimes used in emergencies for anaphylactic reactions.
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Dose of Epinephrine in Dogs, Cats, Horses and All Animals

Dose of Epinephrine in Dogs and Cats:

  • Cardiopulmonary Arrest (CPA): 10 ฮผg (micrograms)/kg of a 1:1000 solution (1000 ฮผg/ml) administered i.v. or intraosseously every 3โ€“5 minutes. High-dose epinephrine (0.1 mg/kg i.v.) may be considered in cases of prolonged CPA.
  • Bronchoconstriction and Anaphylaxis: 10 ฮผg (micrograms)/kg of a 1:1000 solution (1000 ฮผg/ml) i.v. or i.m. The i.v. route is preferred if hypotension accompanies the anaphylactoid reaction.

Dose of Epinephrine in Horses:

Typically administered at 0.01โ€“0.02 mg/kg i.v. for emergency situations like anaphylaxis or cardiac arrest.

Dose of Epinephrine in Cattle, Sheep and Goats:

Emergency dosages vary but are generally within the range of 0.01โ€“0.02 mg/kg i.v. or i.m., adjusted based on the severity of the situation and the animalโ€™s size.

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Side Effects of Epinephrine in Dogs, Cats, Horses and All Animals

  • Arrhythmias: May cause arrhythmias, including ventricular fibrillation, due to increased myocardial oxygen demand.
  • Tachycardia: Can induce rapid heart rates.
  • Other Adverse Effects: Include dry mouth, cold extremities, and repeated injections potentially leading to necrosis at the injection site.
  • Horses: Use cautiously as it may cause excessive sweating, excitement, and arrhythmias.
  • Livestock: May exhibit similar cardiovascular effects as dogs and cats, including increased heart rate and arrhythmias.

Contraindications of Epinephrine in Dogs, Cats, Horses and All Animals

  • Human Adrenaline Pen Injections: Not recommended for veterinary use as the doses are often too small to be effective.
  • Direct Myocardial Administration: Avoid administering adrenaline directly into the myocardium due to the high risk of inducing arrhythmias.
  • In Horses: Use with caution in cases of pre-existing heart conditions or severe hypovolemia.
  • In Livestock: Avoid in animals with cardiac abnormalities unless in emergency situations.

Some Notes:

  • Diabetes Mellitus: Use with caution and monitor blood glucose levels in diabetic animals.
  • Hypertension/Hyperthyroidism: Avoid in animals with hypertension or hyperthyroidism due to the risk of exacerbating these conditions.
  • Hypovolemic Animals: Exercise caution as epinephrine can worsen hypovolemia.
  • Overdosage: Can be fatal, especially in small animals; dose must be checked meticulously.
  • Drug Interactions:
    1. Antihistamines and Thyroxine: May potentiate the effects of adrenaline.
    2. Propranolol: May block beta effects of adrenaline, potentially increasing blood pressure.
    3. Myocardium-sensitizing Drugs: When used with drugs such as halothane or high doses of digoxin, monitor for signs of arrhythmias.
    4. Oxytocic Agents: Concurrent use may result in hypertension.
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