Uses of Ephedrine: - Hypotension following spinal anesthesia Bronchial asthma, Hypotension, Diabetic neuropathic oedema Hypersensitivity. Hypertension, thyrotoxicosis, BPH. Lactation.

Other adrenoceptor stimulants, Vasoconstrictor/Venotonic

Ephedrine is a stimulant drug, belonging to a group of medicines known as sympathomimetics. Specifically it is both an alpha and beta adrenergic agonist. In addition, Ephedrine enhances the release of norepinephrine, a strong endogenous alpha agonist. The action of this compound is notably similar to that of the body's primary adrenergic hormone epinephrine (adrenaline), which also exhibits action toward both alpha and beta receptors. When administered, Ephedrine will notably increase the activity of the central nervous system, as well as have a stimulatory effect on other target cells.

How to use Ephedrine Hydrochloride: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: May be taken with or without food. IV Preparation Must be diluted before administration as an IV bolus to 5 mg/mL by withdrawing 50 mg (1 mL) dilute with 9 mL 0.9% NaCl or D5W Adult Dose: Oral Acute bronchospasm Adult: As ephedrine HCl: 15-60 mg tid. Max: 150 mg/day. Diabetic neuropathic oedema 30-60 mg 3 times/day. Elderly: Initial: 50% of adult dose. Parenteral Reversal of spinal or epidural anaesthesia-induced hypotension Adult: As ephedrine HCl: 3-6 mg by slow IV inj every 3-4 min as required. Max total dose: 30 mg. Elderly: Same as adult dose. Child Dose: Oral Acute bronchospasm Child: As ephedrine HCl: 1-5 yr 15 mg tid; 6-12 yr 30 mg tid; >12 yr Same as adult dose. Parenteral Reversal of spinal or epidural anaesthesia-induced hypotension Child: 0.5 mg/kg or 16.7 mg/m2 4-6 hrly by SC or IM inj or alternatively, 0.75 mg/kg or 25 mg/m2 4 times daily by SC or IV inj.

Reduces antihypertensive effect of bethanidine and guanethidine. May increase clearance of dexamethasone. Increased incidence of adverse effects when used with theophylline. Potentially Fatal: Severe HTN when combined with MAOIs or withi 2 wk of discontinuance of MAOI treatment. Increased risk of arrhythmias with cardiac glycosides, quinidine or tricyclic antidepressants. Increased vasoconstriction or pressor effects with ergot alkaloids or oxytocin.

Hypersensitivity. Hypertension, thyrotoxicosis, BPH. Lactation.

Common - Systemic hypertension (high blood pressure) - Insomnia (difficulty in sleeping) Gastrointestinal disorders: Nausea, vomiting Cardiac disorders: Tachycardia, palpitations (thumping heart), reactive hypertension, bradycardia, ventricular ectopics, heart rhythm/rate variability Nervous system disorders: Dizziness Psychiatric disorders: Restlessness Potentially Fatal: Delusions, hallucinations. Seen with hypersensitivity and overdosage. Acute CNS and CVS stimulation presenting as vomiting, fever, hypertension, psychosis. Cardiac arrhythmias.

Pregnancy: Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.Lactation: Ephedrine Hydrochloride is distributed into breast milk, and therefore Ephedrine Hydrochloride Injection is not recommended for use during lactation because of the risk of adverse effects in the infant.

Precaution: Ischaemic heart disease, hyperthyroidism, diabetes mellitus, hypertension, angle-closure glaucoma, renal impairment; prostatic enlargement; pregnancy, elderly. Lactation Unknown if excreted in breast milk

When given in sufficiently large doses Ephedrine gives rise in most patients to certain minor reactions, such as giddiness, headache, nausea, vomiting, sweating, palpitations, difficulty in micturition, tremors, anxiety, restlessness and insomnia; some patients may exhibit these symptoms even with the usual therapeutic dosage.

Store in a cool, dry place, protected from light. Keep all medicines out of reach of children.

Other adrenoceptor stimulants, Vasoconstrictor/Venotonic

Ephedrine has both alpha- and beta-adrenergic acitivity with pronounced stimulating effects on the CNS. It increases cardiac output, induces peripheral vasoconstriction, bronchodilation, reduces intestinal tone and motility, and relaxes the bladder while contracting the sphincter muscle. It also has stimulant action on the resp center and dilates the pupil witho affecting light reflexes.

Pregnancy Ephedrine crosses the placenta; used at deliver for prevention and/or treatment of maternal hypotension associated with spinal anesthesia Fetal/neonatal adverse reactions Cases of potential metabolic acidosis in newborns at delivery with maternal ephedrine exposure have been reported in the literature These reports describe umbilical artery pH of ?7.2 at the time of delivery Monitor newborn for signs and symptoms of metabolic acidosis Monitoring of infant’s acid-base status is warranted to ensure that an episode of acidosis is acute and reversible Lactation Unknown if excreted in breast milk