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Epinephrine is also used as a bronchodilator for asthma if specific β 2 agonists are unavailable or ineffective. [39] Because of the high intrinsic efficacy (receptor binding ability) of epinephrine, high drug concentrations cause adverse side effects when treating asthma. The value of using nebulized epinephrine in acute asthma is unclear. [40]
Common side effects include shakiness, anxiety, and sweating. A fast heart rate and high blood pressure may occur. Occasionally it may result in an abnormal heart rhythm. While the safety of its use during pregnancy and breastfeeding is unclear, the benefits to the mother must be taken into account. [8]
Serious side effects may include worsening asthma, anaphylaxis, seizures, and heart problems. [5] Safety in pregnancy and breastfeeding is unclear. [ 6 ] Fluticasone, a corticosteroid , works by decreasing inflammation while salmeterol, a long-acting beta-adrenoceptor agonist (LABA), works by activating beta-2 adrenergic receptors .
It is available mixed with a small amount of epinephrine to increase the duration of its action. [5] It typically begins working within 15 minutes and lasts for 2 to 8 hours. [5] [6] Possible side effects include sleepiness, muscle twitching, ringing in the ears, changes in vision, low blood pressure, and an irregular heart rate. [5]
Since the fetus is smaller and does not have a fully developed liver, the concentration of alcohol in its bloodstream lasts longer, increasing the chances of detrimental side effects. [69] The severity of effects alcohol may have on a developing fetus depends upon the amount and frequency of alcohol consumed as well as the stage of pregnancy.
[6] [7] Current evidence suggests that first line treatment with β 2 agonists, calcium channel blockers, or NSAIDs to prolong pregnancy for up to 48 hours is the best course of action to allow time for glucocorticoid administration. [1] Various types of agents are used, with varying success rates and side effects.
The Surviving Sepsis Campaign guidelines recommend the very early management of the sepsis focusing on the hour-1 bundle. This includes use of Vasopressin 0.03 units/minute as add-on to norepinephrine (NE) with intent of either raising the mean arterial pressure or decreasing the norepinephrine dosage (i.e. de-catecholaminization).
Side effects of dipivefrine include local eye reactions among others. Dipivefrine is a prodrug of epinephrine (adrenaline) and hence acts as a non-selective adrenergic receptor agonist . [ 5 ] It is a substituted phenethylamine and catecholamine and is an ester of epinephrine with much greater fat solubility .