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Small molecule
PubChem CID 5816

Epinephrine

EpiPen
Mechanism of action
Non-selective alpha/beta-adrenergic , reverses vasodilation and bronchospasm
In plain language
Activates the body's fight-or-flight adrenaline all at once, tightening blood vessels to raise dangerously low blood pressure, relaxing the airways to make breathing easier, and calming the swelling and itching of a severe allergic reaction, all within minutes of injection.
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How it works
Epinephrine (EpiPen) is a non-selective alpha- and beta-adrenergic receptor agonist. Per the FDA label, through its action on alpha-adrenergic receptors, epinephrine lessens the vasodilation and increased vascular permeability that occur during anaphylaxis, which can otherwise lead to loss of intravascular fluid volume and hypotension. Through its action on beta-adrenergic receptors, epinephrine causes bronchial smooth muscle relaxation and helps relieve the bronchospasm, wheezing, and dyspnea that can occur during anaphylaxis; it also alleviates pruritus, urticaria, and angioedema. Given intramuscularly or subcutaneously, epinephrine has a rapid onset and short duration of action.
Therapeutic applications
EpiPen and EpiPen Jr auto-injectors are FDA-indicated for the emergency treatment of allergic reactions (Type I), including anaphylaxis, to stinging or biting insects, allergen immunotherapy, foods, drugs, diagnostic testing substances, and other allergens, as well as idiopathic or exercise-induced anaphylaxis, in patients determined to be at increased risk. The label carries no contraindications, reflecting that epinephrine should not be withheld in a genuine anaphylactic emergency; however, large doses or accidental intravenous injection can cause a sharp rise in blood pressure, and the label advises caution in patients with heart disease. Patients must seek immediate emergency medical care after every use, since epinephrine's effects can wear off before the allergic reaction has resolved.
Class
Therapeutic area
Emergency / Cardiovascular
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