エピネフリン

使用用途

• Anaphylaxis
• Anaphylaxis
• Cardiac resuscitation (asystole)
• Cardiac resuscitation
• Cardiac resuscitation
• Neonatal resuscitation (when respiratory support/compressions fail)
• Anaphylaxis
• Anaphylaxis
• Bronchoconstriction
• Hypotension associated with anesthesia
• Hypotension associated with anesthesia
• Cardiopulmonary arrest (CPA)
• Bronchoconstriction and anaphylaxis
• Emergency management

投与方法

考えられる副作用

• Anxiety and fear
• Tremors and excitability
• Vomiting
• Hypertension (especially with overdosage)
• Cardiac arrhythmias (especially with pre-existing heart disease)
• Hyperuricemia
• Lactic acidosis (with prolonged use or overdose)
• Tissue necrosis and sloughing at the injection site (with repeated injections or injection into small appendages)

注意事項と禁忌

• Narrow-angle glaucoma
• Hypersensitivity to epinephrine
• Shock due to non-anaphylactoid causes
• During general anesthesia with halogenated hydrocarbons or cyclopropane
• During labor (may delay the second stage)
• Cardiac dilatation or coronary insufficiency
• Conditions where vasopressors are contraindicated (e.g., thyrotoxicosis, diabetes, hypertension, toxemia of pregnancy)
• Injection with local anesthetics into small appendages (toes, ears, etc.) due to risk of necrosis
• **Hypovolemia:** Epinephrine is not a substitute for adequate fluid volume replacement therapy. **Cardiac Rhythms:** Use with extreme caution in patients with a prefibrillatory cardiac rhythm due to excitatory effects on the heart. While useful in asystole, it can cause ventricular fibrillation; use cautiously in cases of existing ventricular fibrillation. **Tissue Necrosis:** Do not inject into small appendages (ears, toes, tails) as profound vasoconstriction can cause ischemic necrosis and sloughing. **Concentration Errors:** Always double-check the concentration (1:1,000 vs 1:10,000) before administration to avoid fatal overdoses.

薬物相互作用

• Alpha-blockers (phentolamine, phenoxybenzamine, prazosin): May negate the therapeutic effects of epinephrine.
• Alpha-2 agonists (detomidine, dexmedetomidine, xylazine): Do NOT use epinephrine to treat cardiac effects caused by alpha-2 agonists; may worsen hemodynamics.
• General Anesthetics (halogenated hydrocarbons, cyclopropane): Increased risk of developing severe arrhythmias. Propranolol may be used to treat if they occur.
• Antihistamines (diphenhydramine, chlorpheniramine): May potentiate the effects of epinephrine.
• Beta-blockers (propranolol): May potentiate hypertension and antagonize epinephrine's cardiac and bronchodilating effects.
• Digoxin: Increased risk of arrhythmias if used concurrently.
• Nitrates: May reverse the pressor effects of epinephrine.
• Levothyroxine: May potentiate the effects of epinephrine.
• Oxytocic agents: Hypertension may result if used concurrently.
• Other Sympathomimetic agents (isoproterenol): Should not be administered together as increased toxicity may result.

よくある質問