Adrenalin Chloride

Twinject (Adrenalin Chloride, USP 1:1000) is indicated in the emergency treatment of severe allergic reactions (Type I) including anaphylaxis to stinging insects (e.g. order Hymenoptera, which includes bees, wasps, hornets, yellow jackets and fire ants), and biting insects (e.g. triatoma, mosquitos), allergen immunotherapy, foods, drugs, diagnostic testing substances (e.g. radiocontrast media), and other allergens, as well as anaphylaxis to unknown substances (idiopathic anaphylaxis) or exercise-induced anaphylaxis. Twinject is intended for immediate administration in patients with a history of anaphylactic reactions. Selection of the appropriate dosage strength is determined according to patient body weight.

Such reactions may occur within minutes after exposure and consist of flushing, apprehension, syncope, tachycardia, thready or unobtainable pulse associated with a fall in blood pressure, convulsions, vomiting, diarrhea and abdominal cramps, involuntary voiding, wheezing, dyspnea due to laryngeal spasm, pruritus, rashes, urticaria, or angioedema. Twinject is designed as emergency supportive therapy only and is not a replacement or substitute for immediate medical care.

Adrenalin Chloride is a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction.

Adrenalin Chloride is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. Adrenalin Chloride is also used to treat exercise-induced anaphylaxis.

Adrenalin Chloride auto-injectors may be kept on hand for self-injection by a person with a history of an severe allergic reaction.

Adrenalin Chloride may also be used for purposes not listed in this medication guide.

Adrenalin Chloride, USP is administered by intravenous injection and/or in cardiac arrest, by intracardiac injection into the left ventricular chamber or via endotracheal tube directly into the bronchial tree. The adult intravenous dose for hypersensitivity reactions or to relieve bronchospasm usually ranges from 0.1 to 0.25 mg (1 to 2.5 mL of 0.1 mg/mL solution), injected slowly. Neonates may be given a dose of 0.01 mg per kg of body weight; for the infant 0.05 mg is an adequate initial dose and this may be repeated at 20 to 30 minute intervals in the management of asthma attacks.

In cardiac arrest, 0.5 to 1.0 mg (5 to 10 mL of 0.1 mg/mL solution) may be given. During a resuscitation effort, 0.5 mg (5 mL) should be administered intravenously every five minutes.

Intracardiac injection should only be administered by personnel well trained in the technique, if there has not been sufficient time to establish an intravenous route. The intracardiac dose usually ranges from 0.3 to 0.5 mg (3 to 5 mL of 0.1 mg/mL solution).

Alternatively, if the patient has been intubated, Adrenalin Chloride can be injected via the endotracheal tube directly into the bronchial tree at the same dosage as for intravenous injection. It is rapidly absorbed through the lung capillary bed.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

To prevent needle-stick injuries, needles should not be recapped, purposely bent or broken by hand.

See also:
What is the most important information I should know about Adrenalin Chloride?

Adrenalin Chloride is contraindicated in patients with known hypersensitivity to sympathomimetic amines, in patients with angle closure glaucoma, and patients in shock (nonanaphylactic). It should not be used in patients anesthetized with agents such as cyclopropane or halothane as these may sensitize the heart to arrhythmic action of sympathomimetic drugs.

Adrenalin Chloride should not ordinarily be used in those cases where vasopressor drugs may be contraindicated, e.g., in thyrotoxicosis, diabetes, in obstetrics when maternal blood pressure is in excess of 130/80 and in hypertension and other cardiovascular disorders.

Use Adrenalin Chloride as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Adrenalin Chloride. Talk to your pharmacist if you have questions about this information.
• Adrenalin Chloride may be given as an injection at your doctor's office, hospital, or clinic. If you will be using Adrenalin Chloride at home, a health care provider will teach you how to use it. Be sure you understand how to use Adrenalin Chloride. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Check Adrenalin Chloride regularly. Replace Adrenalin Chloride if the expiration date has passed, if it contains particles or is discolored (pink or darker than slightly yellow), or if it is cracked or damaged in any way. If Adrenalin Chloride has been dropped, inspect it for damage or leakage and replace it if necessary.
• Inject Adrenalin Chloride only into the outer thigh, as directed by your health care provider. Do not inject into the buttocks or into a vein.
• Go to the nearest hospital emergency room immediately after use. You may need further medical attention. Tell the doctor or health care provider that you have received an injection of Adrenalin Chloride. Show the thigh where the injection was given to the doctor. Give your used auto-injector to the doctor for inspection and proper disposal.
• Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
• Adrenalin Chloride is usually given in an emergency situation. If you are unable to use Adrenalin Chloride, seek medical attention immediately.
• If you miss a dose of Adrenalin Chloride, seek immediate medical attention.

Ask your health care provider any questions you may have about how to use Adrenalin Chloride.

Acute asthma, anaphylactic shock, advanced cardiac life support, ocular hypertension, open angle glaucoma.

See also:
What other drugs will affect Adrenalin Chloride?

Adrenalin Chloride should be used cautiously in patients with hyperthyroidism, hypertension and cardiac arrhythmias. All vasopressors should be used cautiously in patients taking monoamine oxidase (MAO) inhibitors.

Adrenalin Chloride should not be administered concomitantly with other sympathomimetic drugs (such as isoproterenol) because of possible additive effects and increased toxicity.

Combined effects may induce serious cardiac arrhythmias. They may be administered alternately when the preceding effect of other such drug has subsided.

Administration of Adrenalin Chloride to patients receiving cyclopropane or halogenated hydrocarbon general anesthetics such as halothane which sensitize the myocardium, may induce cardiac arrhythmia.. When encountered, such arrhythmias may respond to administration of a beta-adrenergic blocking drug. Adrenalin Chloride also should be used cautiously with other drugs (e.g., digitalis, glycosides) that sensitize the myocardium to the actions of sympathomimetic drugs.

Diuretic agents may decrease vascular response to pressor drugs such as Adrenalin Chloride.

Adrenalin Chloride may antagonize the neuron blockade produced by guanethidine resulting in decreased antihypertensive effect and requiring increased dosage of the latter.

See also:
What are the possible side effects of Adrenalin Chloride?

Applies to Adrenalin Chloride: injection injectable, injection solution

In addition to its needed effects, some unwanted effects may be caused by Adrenalin Chloride (the active ingredient contained in Adrenalin Chloride). In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking Adrenalin Chloride:

Incidence not known:

• Abnormal or decreased touch sensation
• arm, back, or jaw pain
• bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
• blurred vision
• chest pain or discomfort
• chest tightness or heaviness
• dizziness
• fainting
• fast, irregular, pounding, or racing heartbeat or pulse
• fear or nervousness
• headache
• nausea or vomiting
• paleness of the skin
• pounding in the ears
• restlessness
• shakiness in the legs, arms, hands, or feet
• slow or fast heartbeat
• stroke
• sweating
• trembling or shaking of the hands or feet
• troubled breathing
• unusual tiredness or weakness

If any of the following symptoms of overdose occur while taking Adrenalin Chloride, get emergency help immediately:

Symptoms of overdose:

• Agitation
• coldness of the skin
• coma
• confusion
• decreased urine output
• depression
• drowsiness
• hostility
• irritability
• lethargy
• lightheadedness, dizziness, or fainting
• muscle twitching
• pounding, slow heartbeat
• rapid weight gain
• rapid, deep breathing
• seizures
• stomach cramps
• stupor
• swelling of the face, ankles, or hands

The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics.