Racemic epinephrine
Encyclopedia
Racemic epinephrine is a racemic
Racemic
In chemistry, a racemic mixture, or racemate , is one that has equal amounts of left- and right-handed enantiomers of a chiral molecule. The first known racemic mixture was "racemic acid", which Louis Pasteur found to be a mixture of the two enantiomeric isomers of tartaric acid.- Nomenclature :A...

 mixture of epinephrine
Epinephrine
Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...

 and is a sympathomimetic bronchodilator which is delivered by aerosol. Commonly used in croup (laryngotracheobronchitis) and when stridor is present after removal of an endotracheal tube (extubation).

Indications

Racemic epinephrine may be indicated when there is stridor
Stridor
Stridor is a high pitched wheezing sound resulting from turbulent air flow in the upper airway. Stridor is a physical sign which is produced by narrow or obstructed airway path. It can be inspiratory, expiratory or biphasic . Inspiratory stridor is common...

 present or when croup is suspected.

Contraindications

Racemic epinephrine should not be used in cases of epiglottitis
Epiglottitis
Epiglottitis is an inflammation of the epiglottis - the flap that sits at the base of the tongue, which keeps food from going into the trachea . Due to its place in the airway, swelling of this structure can interfere with breathing and constitutes a medical emergency...

 or hypersensitivity to the drug.

Side effects

Side effects include increased heart rate, nausea, anxiety, heart palpitations and headache.

Mechanism of action

Racemic epinephrine works by stimulation of the α-adrenergic receptors in the airway with resultant tightening of the mucosa (mucosal vasoconstriction) and decreased fluid in the airway (subglottic edema) and by stimulation of the β-adrenergic receptors causing relaxation of the bronchial smooth muscle.

Dosage

  • Adults — 0.5-0.75 ml of a 2.25% solution in 2.0 ml normal saline.
  • Pediatrics — 0.25-0.75 ml of a 2.25% solution in 2.0 ml normal saline.

See also

  • Epinephrine
    Epinephrine
    Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...

  • Beclometasone dipropionate
    Beclometasone dipropionate
    Beclometasone dipropionate or beclomethasone dipropionate , also referred to as beclometasone , is a potent glucocorticoid steroid. In the form of an inhaler , a wide number of brands of which are available, it is used for the prophylaxis of asthma. As a nasal spray Beclometasone dipropionate (INN...

  • Ipratropium
    Ipratropium
    Ipratropium bromide is an anticholinergic drug used for the treatment of chronic obstructive pulmonary disease and acute asthma. It blocks the muscarinic acetylcholine receptors in the smooth muscles of the bronchi in the lungs, opening the bronchi...

  • Ipratropium/salbutamol
    Ipratropium/salbutamol
    The combination preparation ipratropium bromide/salbutamol is a formulation containing ipratropium bromide and salbutamol sulfate used in the management of chronic obstructive pulmonary disease and asthma...

  • Levalbuterol
    Levalbuterol
    Levosalbutamol or levalbuterol , trade name Xopenex, is the R-enantiomer of the short-acting β2-adrenergic receptor agonist salbutamol. It is marketed by Cipla as Levolin, & by axa named Axazest.-Uses:...

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