The dose ranges from 0.1 to 0.5 mg (ml equals mg with this concentration). An intramuscular injection delivers medication into a muscle. People may wonder if they should administer epinephrine if they suspect but aren't sure that they are having an anaphylactic reaction. Following intravenous administration of epinephrine, increases in systolic blood pressure and heart rate are observed. Inspect visually for particulate matter and discoloration prior to administration; solution should be clear and colorless. Because of the potential for cardiovascular adverse events, IV epinephrine should only be administered for anaphylaxis in profoundly hypotensive patients or patients in cardiac or respiratory arrest who have failed to respond to IV volume replacement and multiple IM doses of epinephrine. This also may progress on rare occasions to superficial slough. EpiPenis also available in New Zealand (Pharmac listed since 1 February 2023). Epinephrine is sometimes given as an infusion into a vein. Do not administer repeated injections at the same site, as the resulting vasoconstriction may cause tissue necrosis. Therefore, injected adrenaline assists the body's natural response. This medicine is injected under the skin or into the muscle of your outer thigh only. This content does not have an English version. Pregnant women experiencing anaphylaxis require the same dose of IM adrenaline as other patients. Do not store the medicine in the refrigerator or freezer, or into your vehicle's glove box. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. Give the intramuscular injection of adrenaline into your outer mid-thigh. Epinephrine is in a class of medications called alpha- and beta-adrenergic agonists (sympathomimetic agents). Do not put your thumb, fingers, or hand over the black base (Auvi-Q), orange (EpiPen or EpiPen Jr), or red (Adrenaclick) tip of the autoinjector or over the needle of the Symjepi prefilled syringe. Follow your doctor's orders or the directions on the label. Epinephrine, when injected into an intravenous fluid solution, will increase the coronary artery pressure thereby promoting increased coronary blood flow. To provide hemodynamic support in septic shock associated hypotension in adult patients, the suggested dosing infusion rate of intravenously administered epinephrine is 0.05 to 2 mcg/kg/min, and is titrated to achieve a desired mean arterial pressure (MAP). Anylink to a third-party websitedoes not implyany endorsement by ASCIA. Administer IV Adrenaline as a bolus. Package insert / product label Before any vaccine is given, consent must be obtained (see Chapter 2) and . A patient with anaphylaxis, or suspected anaphylaxis, is administered adrenaline intramuscularly without delay, before any other treatment including asthma medicines. Do not use if the solution is colored or cloudy, or if it contains particulate matter. Rare cases of serious skin and soft tissue infections, including necrotizing fasciitis and myonecrosis caused by Clostridia (gas gangrene), have been reported following epinephrine injection in the thigh [see Warnings and Precautions (5.2)]. This will ensure that adrenaline is readily accessible to any clinician who may administer it, including prn orders for IM adrenaline. Protect from light and freezing. How do you administer adrenaline injections? Policy. IM absorption depends upon blood flow. Push the plunger all the way down until you hear a "clicking" sound. The autoinjector needs to stay in place for a minimum of 3 seconds following activation. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Management of anaphylaxis during pregnancy is similar to management in the general population. Do not use this medicine if the liquid has changed its color (pinkish or brown in color), has become cloudy, or if there are particles in it. Children weighing less than 15 kgUse and dose must be determined by your doctor. Health conditions that result from low levels of epinephrine include: Health conditions that result from high levels of epinephrine include: Epinephrine is both a neurotransmitter and a hormone, but it acts mainly as a hormone. Last updated on Jul 22, 2022. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota. According to Dr. Brown, studies have shown there is epinephrine in your system for at least 6 hours. Most healthcare providers likely to deal with anaphylaxis in the healthcare setting should have the skills to draw up adrenaline and give an intramuscular injection of adrenaline. Do not reuse the remaining portion of the medicine that is left in the autoinjector, prefilled syringe, or vial. Trouble sleeping. Treatment of arrhythmias consists of administration of a beta-adrenergic blocking drug (such as propranolol). Treatment of pulmonary edema consists of a rapidly acting alpha-adrenergic blocking drug (such as phentolamine mesylate) and respiratory support. Abnormal levels are linked to sleep disorders, anxiety, hypertension and lowered immunity. Add Image Creator to sidebar. Injection into the buttock may not provide effective treatment of anaphylaxis and has been associated with the development of Clostridial infections (gas gangrene). All rights reserved. Pain, redness, or irritation at site where injected. Adrenaline injectors contain a single, fixed dose of adrenaline, and have been designed to be given by non-medical people, such as a friend, teacher, children's education/care worker, parent, passer-by or by the patient themselves (if they are not too unwell to do this). Its also used as a medication to treat many life-threatening conditions. Factors that influence the choice of muscle to use for an intramuscular injection include the patient's size, as well as the amount, viscosity, and type of medication. Most vaccines should be given by intramuscular (IM) injection. Identify and avoid the cause where possible. Do not inject this medicine into your hands or feet. The answer is yes. Cleveland Clinic is a non-profit academic medical center. If epinephrine is accidently injected into these areas, get emergency medical treatment immediately. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Adrenalin is a registered trademark of Par Pharmaceutical, Inc. Novaplus is a registered trademark of Vizient, Inc. In dosage sufficient to reduce uterine contractions, the drug may cause a prolonged period of uterine atony with hemorrhage. These effects were not seen in mice at approximately 2 times the maximum recommended daily intramuscular or subcutaneous dose (on a mg/m2 basis at a subcutaneous maternal dose of 0.5 mg/kg/day for 10 days). The ideal route of epinephrine injection in anaphylaxis has not been well established in clinical trials, and perhaps this cannot be tested because of ethical considerations. Warn patients with a good response to initial treatment about the possibility of recurrence of symptoms and instruct patients to obtain proper medical attention if symptoms return. The shelf life of adrenaline is normally one or two years from the date of supply. It is recommended that you practise using the trainer device at least every three to four months. Data sources include IBM Watson Micromedex (updated 1 May 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Following intravenous injection, epinephrine is rapidly cleared from the plasma with an effective half-life of < 5 minutes. During the fight-or-flight response, you (your brain) perceive danger. Press the device firmly into the thigh so that the needle can administer the epinephrine dose. Home | About | Contact | Copyright | Report Content | Privacy | Cookie Policy | Terms & Conditions | Sitemap. As a central nervous system neurotransmitter, its a chemical messenger that helps transmit nerve signals across nerve endings to another nerve cell, muscle cell or gland cell. This medicine comes with an autoinjector trainer and a separate trainer instructions for use. It is also the least painful part of the body to give an injection. Ensure that clinicians have training in the management of anaphylaxis and are practised using adrenaline injector or pen devices. Higher body weight was associated with a higher plasma epinephrine clearance and a lower concentration plateau. It is given through a needle placed into one of your veins. Increased doses of epinephrine quicken the response, but some studies have shown that brain and heart damage are some of the side effects. The chemical name of epinephrine is: 1,2-Benzenediol, 4-[(1R)-1-hydroxy-2-(methylamino)ethyl]-, or (-)-3,4-Dihydroxy--[2-(methylamino)ethyl]benzyl alcohol. Children weighing 7.5 to 15 kg0.1 mg injected under the skin or into the muscle of your thigh. Get emergency medical help right away after the . After the latest update is applied, check the right sidebar of Edge for the Image Creator icon. Ensure that there is a protocol for the management of anaphylaxis in place that supports prompt administration of IM adrenaline by all relevant clinicians, including nurses. Avoiding adrenaline use in the case of a severe allergic reaction, or preferentially using corticosteroids, bronchodilators or antihistamines, may inadvertently give a message to patients that they should delay using their adrenaline injector, thus increasing potential risk in a subsequent anaphylaxis. If anaphylaxis occurs after injection of allergen-specific subcutaneous immunotherapy (SCIT), a large local reaction often occurs. If you use the Symjepi prefilled syringe: You may need to use more than one injection if your allergic reaction does not get better after the first shot. They must not walk to or from the ambulance even if they appear to have improved or recovered. They reach your eyes, heart, airways, blood vessels in your skin and your adrenal gland again. Use this medicine only as directed by your doctor. The prevalence of anaphylaxis occurring during pregnancy is reported to be approximately 3 cases per 100,000 deliveries. If anaphylaxis is suspected in the presence of an allergy or anaphylaxis history, or following exposure to a potential allergen, it is safer to administer adrenaline early than to wait for progression, which may be hard to reverse. Adrenaline is a natural hormone released in response to stress. Get useful, helpful and relevant health + wellness information. Pain, redness, or irritation at site where injected. There is already less blood flow to the hands and feet, and epinephrine could make that worse and cause damage to these tissues. Subsidence of the ventricular effects may be followed by atrial tachycardia and occasionally by atrioventricular block. Premature ventricular contractions may appear within one minute after injection and may be followed by multifocal ventricular tachycardia (prefibrillation rhythm). The amount of medicine that you take depends on the strength of the medicine. Injection into the buttock has resulted in cases of gas gangrene [see Warnings and Precautions (5.1)]. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice. Adrenaline is absorbed most rapidly when injected into the outer mid-thigh muscle. Emergency treatment of allergic reactions (Type I), including anaphylaxis, which may result from insect stings or bites, foods, drugs, sera, diagnostic testing substances and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis. Do not inject into a vein, the buttocks, fingers, hands or feet. Its at a higher level for about an hour, and it peaks around 5 minutes. In an embryofetal development study with pregnant hamsters dosed during the period of organogenesis from gestation days 7 to 10, epinephrine produced reductions in litter size and delayed skeletal ossification at doses approximately 2 times the maximum recommended intramuscular, subcutaneous, or intravenous dose (on a mg/m2 basis at a maternal subcutaneous dose of 0.5 mg/kg/day). It plays an important role in your bodys fight-or-flight response. Psychiatric: anxiety, apprehensiveness, restlessness. Do Men Still Wear Button Holes At Weddings? Adults and children weighing 30 kilograms (kg) or more0.3 to 0.5 milligram (mg) injected under the skin or into the muscle of your thigh. Give INTRAMUSCULAR INJECTION (IMI) OF ADRENALINE (1:1000) into outer mid-thigh (0.01mg per kg up to 0.5mg per dose) without delay using an adrenaline autoinjector if available OR adrenaline ampoule and syringe, as shown in the table below: *Adrenaline 1:1,000 ampoules contain 1mg adrenaline per 1mL Can delay second stage of labour. Epinephrine solution deteriorates rapidly on exposure to air or light, turning pink from oxidation to adrenochrome and brown from the formation of melanin. The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. This canexpedite the administration of IM adrenaline if the patient experiences anaphylaxis while in care. Why is epinephrine given in thigh? Do not flip the blue safety release off using the thumb or by pulling it sideways, or by bending and twisting it. Be sure to practice first with your autoinjector trainer before an allergy emergency happens to make sure you are ready to use the real Auvi-Q, Adrenaclick, EpiPen, or EpiPen Jr autoinjector in an actual emergency. The ASCIA website is intended for use by ASCIA members, health professionals and the general public. Anna University, Chennai. This reaction causes a number of changes in your body and is known as the fight-or-flight response. Injections given intramuscularly, rather than deep subcutaneously, are less likely to cause . The medicine should start working almost immediately. In a critical care setting where there is appropriate haemodynamic monitoring available. There is no information regarding the presence of epinephrine in human milk or the effects of epinephrine on the breastfed infant or on milk production. When used as a medication, synthetic epinephrine is used to treat: Side effects of epinephrine as an aerosol or injection that require medical attention include: Plus the first five side effects listed under aerosol above. PRINCIPAL DISPLAY PANEL - 30 mL Vial Label, For Intravenous Infusion, Intramuscular and Subcutaneous Use, EpiPen, Primatene Mist, Auvi-Q, Adrenaclick, +3 more, prednisone, albuterol, loratadine, methylprednisolone, dexamethasone, triamcinolone, promethazine, Benadryl, hydrocortisone, diphenhydramine. This medicine comes with patient information and instructions leaflet. Its also used as a medication to treat many life-threatening conditions. Clinical use data support weight-based dosing for treatment of anaphylaxis in pediatric patients, and other reported clinical experience with the use of epinephrine suggests that the adverse reactions seen in children are similar in nature and extent to those both expected and reported in adults. The needle used for injection needs to be sufficiently long to ensure that the adrenaline is injected into muscle. Adrenaline lessens the effects of anaphylaxis by reducing throat swelling, opening the airways, and maintaining heart function and blood pressure. This however, is the worst-case scenario. Adrenaline is a natural hormone released in response to stress. dilute 1 ampoule (1 mL) of adrenaline 1:1000 with 9 mL water for injection or normal saline. If your dose is different, do not change it unless your doctor tells you to do so. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. It should be clear and colorless. Recent findings: The most important recent finding regarding the administration of epinephrine is that the intramuscular route of administration is the route of choice for the treatment of anaphylaxis, and the lateral aspect of the thigh is the site of choice. Include a when required (prn) order for IM adrenaline on an admitted patients medication chart if they have a known allergy and have been prescribed an adrenaline injector. To do so, may increase the chance of having serious side effects. Epinephrine may induce cardiac arrhythmias and myocardial ischemia in patients, especially patients suffering from coronary artery disease, or cardiomyopathy. Children less than 30 kg (66 lbs): 0.01 mg/kg (0.01 mL/kg) of undiluted Adrenalin administered intramuscularly or subcutaneously in the anterolateral aspect of the thigh, up to a maximum of 0.3 mg (0.3 mL) per injection, repeated every 5 to 10 minutes as necessary. It plays a role in metabolism, attention, focus, panic and excitement. Animals treated on days 6 to 7 had decreased number of implantations. Epinephrine injection is used along with emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, foods, medications, latex, and other causes. Generic name: epinephrine If you are about to use the autoinjector, pull up straight the blue safety release (EpiPen or EpiPen Jr) with one hand and hold the pen with the other hand. There are three doses of adrenaline injectors: Each adrenaline injectorcontains a single fixed dose of adrenaline. This is a simple description of the fight-or-flight response. Your pupils grow larger and you sweat. Guidance for doses of intramuscular 1:1000 adrenaline for anaphylaxis based on weight in kgs. Adrenaline injectors (150 micrograms) are usually prescribed for children weighing 7.5-20kg (e.g. Ask your healthcare professional how you should dispose of any medicine you do not use. Do not administer corticosteroids or antihistamines first-line, as they are not effective in treating anaphylaxis. In conjunction with the administration of epinephrine, the patient should seek immediate medical or hospital care. Intramuscular and subcutaneous use for anaphylaxis. This may activate the device by accident (a "click is heard, the orange needle is extended, and the window is blocked), making it unusable in case of an emergency. Can you use an expired EpiPen in an emergency? Injection into (or near) smaller muscles, such as in the deltoid, is not recommended. Overproduction of adrenaline is very common. This document has been developed by ASCIA, the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. If repeated adrenaline doses are needed, start an IV adrenaline infusion with reference to local guidelines on the preparation and infusion of adrenaline. Observation time following anaphylaxis, 6. Other parts of your nervous system are also involved, as well as other organ systems, hormones and neurotransmitters. In patients with septic shock, epinephrine displays dose-proportional pharmacokinetics in the infusion dose range of 0.03 to 1.7 mcg/kg/min. Adverse events have been reported in adult patients who received overdoses of IV adrenaline, but these are rare with IM adrenaline. Trouble passing urine or change in the amount of urine. Advertising revenue supports our not-for-profit mission. Catechol-O-methyl transferase (COMT) inhibitors, such as entacapone. Dosage form: injection 31st Mar, 2012. yes in an emergency where the heart rate should be raised suddenly adrenaline is pushed into the blood vessel (but not more than 0.5ml ) directly which . Monitor clinically for reaction severity and cardiac effects. If unconscious, place them in the recovery position (on their side). Injection into the anterolateral aspect of the thigh (vastus lateralis muscle) is the most appropriate location for administration because of its location, size, and available blood flow. This should not prevent the use of epinephrine under the conditions noted under Indications and Usage (1). As a hormone, its made and released by your adrenal glands, which are hat-shaped glands that sit on top of each kidney. Adrenaline dose ~ <1 year (<7.5 kg) 0.10 mL ~ 1-2 years (10 kg) 0.10 mL ~ 2-3 years (15 kg) 0.15 mL ~ 4-6 years (20 kg) 0.20 mL ~ 7-10 years (30 kg) It can be injected through clothing if needed. Epinephrine is a hormone made by the adrenal glands. As opposed to the upper arm, the thigh muscle is one of the body's largest muscles with more blood supply, so it allows much faster absorption of the medication. Epinephrine causes mydriasis when administered parenterally. (https://www.drugs.com/medical-answers/norepinephrine-epinephrine-difference-3132946/), (https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/adrenaline), (https://www.statpearls.com/articlelibrary/viewarticle/21248/), Yes, its the most common NT of your sympathetic nervous system; mainly works as an NT, Mainly works to increase or maintain blood pressure, Severe asthma, anaphylaxis, low blood pressure from severe conditions. TimesMojo is a social question-and-answer website where you can get all the answers to your questions. feeling restless, fearful, nervous, anxious, or excited. Do not inject epinephrine into the buttocks or any other part of your body such as fingers, hands, or feet or into a vein. Do not inject into buttock. This medicine is injected under the skin or into the muscle of your outer thigh only. The hormone adrenaline makes your heart and lungs work faster, which sends more oxygen to your major muscles. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. The true incidence of adverse reactions associated with the systemic use of epinephrine is difficult to determine. Copyright 2023 ACSQHC. Adults and Children 30 kg (66 lbs) or more: 0.3 to 0.5 mg (0.3 to 0.5 mL) of undiluted Adrenalin administered intramuscularly or subcutaneously in the anterolateral aspect of the thigh, up to a maximum of 0.5 mg (0.5 mL) per injection, repeated every 5 to 10 minutes as necessary. Whenever possible, give infusions of epinephrine into a large vein. Neurological: disorientation, impaired memory, panic, psychomotor agitation, sleepiness, tingling. You may inject the medicine through your clothing, if you need to. Start the epinephrine infusion at 0.1 mcg/kg/minute using a programmable infusion pump while continuously monitoring the patients cardiac rhythm and blood pressure (ie, approximately 6 to 10 mcg/minute in most adults). A dose of 50 micrograms is equivalent to 0.5ml. Fluphenazine Decanoate Injection may be given IM or SC. When administering to a child, to minimize the risk of injection related injury, hold the leg firmly in place and limit movement prior to and during an injection. Do not inject into digits, hands, or feet. Drug information provided by: Merative, Micromedex. Epinephrine, also called adrenaline, is both a hormone and a neurotransmitter. As a hormone, epinephrine is made from norepinephrine inside of your adrenal gland. When you recognise the signs of anaphylaxis, use your adrenaline injector without delay (if you have been prescribed one) and call for help immediately. Norepinephrine vs epinephrine: what's the difference? Epinephrine usually inhibits spontaneous or oxytocin induced contractions of the pregnant human uterus and may delay the second stage of labor. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. The potential for epinephrine to impair reproductive performance has not been evaluated, but epinephrine has been shown to decrease implantation in female rabbits dosed subcutaneously with 1.2 mg/kg/day (15-fold the highest human intramuscular or subcutaneous daily dose) during gestation days 3 to 9. 1. However, there are risks to the mother and fetus associated with epinephrine use during labor or delivery (see Clinical Considerations). Have an ASCIA Action Plan for Anaphylaxis and adrenaline injector close by (easily accessible) to treat if accidental exposure occurs. EMMY NOMINATIONS 2022: Outstanding Limited Or Anthology Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Supporting Actor In A Comedy Series, EMMY NOMINATIONS 2022: Outstanding Lead Actress In A Limited Or Anthology Series Or Movie, EMMY NOMINATIONS 2022: Outstanding Lead Actor In A Limited Or Anthology Series Or Movie. ASCIA PCC Adrenaline for Treatment of Anaphylaxis 2023133.86 KB. Throw away expired, unwanted, or unused EpiPen or EpiPen Jr in an FDA-cleared sharps container. Anaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Now is the time to also reappraise some of the perennial dogma that limits the use of intravenous adrenaline in acute, severe anaphylaxis. This content does not have an Arabic version. Whilst needles may sometimes hurt, you have to remember why you are using it and that adrenaline can be life-saving. Epinephrines major action is in its role as a hormone. Adrenaline can increase the likelihood that the heart will regain a normal rhythm as it directs blood flow to the heart. If prolonged hypotension follows such measures, it may be necessary to administer another pressor drug. EpiPen, Adrenaline injectors(300 micrograms) are usually prescribed for children over 20kg and adults, including pregnant women (e.g. Where do you inject adrenaline for anaphylaxis? The injection may be repeated every 5 to 10 minutes as necessary. Epinephrine is the first line-medication of choice for treatment of anaphylaxis; it should be used in the same manner in pregnant and non-pregnant patients. If your childs symptoms have not improved 5 minutes after using the auto-injector, give another dose of adrenaline using a new pen. Copyright: Merative US L.P. 1973, 2023. Hold in place for 10 seconds. Theyre given this name because of a certain molecule in its structure. Hence, if blanching occurs, consider changing the infusion site at intervals to allow the effects of local vasoconstriction to subside. Disease-associated maternal and/or embryo/fetal risk. Plus the first five side effects listed under "aerosol" above. Epinephrine overdose, which can lead to high blood pressure, stroke and death. Adrenalin diluted in 5 percent dextrose solutions or 5 percent dextrose and sodium chloride solutions are stable for 4 hours at room temperature or 24 hours under refrigerated conditions. Trouble passing urine or change in the amount of urine. Epinephrine injection is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. However, due to its poor oral bioavailability and short half-life, epinephrine exposure is expected to be very low in the breastfed infant. If you are not sure, it is safer to use adrenaline than to wait for your symptoms to get worse. Epinephrine should be administered . Advise patients to seek medical care if they develop signs or symptoms of infection, such as persistent redness, warmth, swelling, or tenderness, at the epinephrine injection site. Do not keep outdated medicine or medicine no longer needed. The neurotransmitter that transmits your brains nervous system message of what to do is norepinephrine (noradrenaline). There is potential for gangrene in a lower extremity when infusions of catecholamine are given in an ankle vein. Access to a personal adrenaline injector in all healthcare settings, 5. Immediate injection of intramuscular adrenaline, National Safety and Quality Health Service (NSQHS) Standards, National Safety and Quality Primary and Community Healthcare Standards, 4. Epinephrine is released by your adrenal glands in response to stress. The outer thigh, versus the front of the thigh, is recommended because it provides a skin area with thinner tissue and less fat. Inspect visually for particulate matter and discoloration prior to administration. Adrenaline (Epinephrine) Injection (1:1000) for Anaphylaxis (glass prefilled syringe) Active Ingredient: adrenaline acid tartrate Company: Martindale Pharma, an Ethypharm Group Company See contact details ATC code: C01CA24 About Medicine Prescription only medicine Healthcare Professionals (SmPC) Patient Leaflet (PIL) The dosage may be adjusted periodically, such as every 10 to 15 minutes, in increments of 0.05 to 0.2 mcg/kg/min, to achieve the desired blood pressure goal. Anaphylaxis is a life-threatening reaction with respiratory, cardiovascular, cutaneous, or gastrointestinal manifestations resulting from exposure to an offending agent, usually a food, insect. Adrenaline may be used to provide rapid relief of severe hypersensitivity reaction to drugs and other allergens, and in the emergency treatment of anaphylactic shock. To do so, may increase the chance of having serious side effects. Store the injection kits at room temperature, away from heat, moisture, and direct light. This signals that the injection has started. If you or your child has been prescribed an adrenaline injector, it is important that you learn and practise how to use it, using a trainer device, that does not contain adrenaline. Carry this medicine with you at all times for emergency use in case you have a severe allergic reaction. Ensure adrenaline injector practise devices are available; the closest adrenaline may be the patients own injector device.

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