Racepinephrine
Indications
For temporary relief of mild symptoms of intermittent asthma: Wheezing, tightness of chest and shortness of breath.
Pharmacology
Racepinephrine is an alpha- and beta-adrenoreceptor stimulant. Racepinephrine works by widening the airways, reducing spasms of bronchial muscles of asthma patients, which makes it easier to breathe.
Dosage And Administration
Adults and children 4 years of age and over-
- Jet Nebulizer: Nebulisation for fifteen minutes every 3 to 4 hours. One 0.5 ml ampoule should be diluted to a volume of 3 to 5 ml with sterile 0.9% sodium chloride solution.
- Hand-held Bulb Nebulizer: 1 to 3 inhalations not more often than every 3 hours. The racepinephrine inhalation solution does not require dilution. Should not use more than 12 inhalations in 24 hours.
Children under 4 years of age: Use according to the physician's direction.
Interaction
Concurrent use with other adrenergic agents will have additive adrenergic side effects. Use with MAO inhibitors may lead to hypertensive crisis. Beta-blockers may negate the therapeutic effect. Tricyclic antidepressants enhance response to epinephrine.
Side Effects
Side effects of Racepinephrine includes headache, loss of appetite, nausea & vomiting, nervousness, tremors, trouble sleeping, fear, agitation, anxiety, restlessness, dizziness, impaired memory, hallucinations, and psychosis. Severe allergic reactions (rash, hives, itching, and difficulty in breathing, swelling of the mouth, face, lips, or tongue), chest pain, fast heartbeat and wheezing may occur. Besides, elevations of heart rate and blood pressure or arrhythmias may occur. Cardiac patients with coronary artery disease or hypertension may worsen condition.
Pregnancy And Lactation
Racemic epinephrine is a 1:1 mixture of the Dextrorotatory and Levorotatory isomers of epinephrine. Epinephrine has been assigned to pregnancy category C by the US FDA. Epinephrine is only recommended for use during pregnancy when there are no alternatives and benefit outweighs the risk. Epinephrine is excreted into human milk. Due to the potential for serious adverse effects in nursing infants, a decision should be made to discontinue nursing or discontinue the drug.
Precautions And Warnings
Racepinephrine should be used cautiously in patients with: cardiac disease (angina, tachycardia, myocardial infarction, hypertension), hyperthyroidism, diabetes, cerebral arteriosclerosis. Excessive use may lead to tolerance and paradoxical bronchospasm. Besides, it is advised not to use Racepinephrine if symptoms are not relieved within 20 minutes or become worse. Racepinephrine solution should not be used if it is brown in color or cloudy, pinkish or if it contains a precipitate.
Overdose Effects
Excessive use may cause nervousness and rapid heartbeat, adverse effects on the heart. In case of overdose, the patient should get medical help right away.
Therapeutic Class
Other adrenoceptor stimulants.
Storage Conditions
Store at 2° to 8°C. Keep away from light and out of the reach of children.