Racepinephrine HCl

Indications

Racepinephrine HCl is used for: Asthma, Stridor, Wheezing

Adult Dose

Adults: Hand-held Bulb Nebulizer: 1 to 3 inhalations not more often than every 3 hours Jet Nebulizer: Administer for fifteen minutes every 3 to 4 hours Do not use more than 12 inhalations in 24 hours.

Child Dose

Children 4 years of age and over: Hand-held Bulb Nebulizer: 1 to 3 inhalations not more often than every 3 hours Jet Nebulizer: Administer for fifteen minutes every 3 to 4 hours Do not use more than 12 inhalations in 24 hours. The use of this product by children should be supervised by an adult.

Renal Dose

Administration

The ingredient is used in an aqueous solution at a concentration equivalent to 1 percent epinephrine For use in a Hand-held Bulb Nebulizer: Racepinephrine inhalation solution does not require dilution For use in a Jet Nebulizer: One 0.5 mL vial should be diluted to a volume of 3 to 5 mL with sterile 0.9% sodium chloride solution

Contra Indications

Hypersensitivity.

Precautions

Asthma alert: Because asthma may be life threatening, see a doctor if you: Are not better in 20 minutes Get worse Need more than 12 inhalations in 24 hours Use more than 9 inhalations in 24 hours for 3 or more days a week Have more than 2 asthma attacks in a week These may be signs that your asthma is getting worse.

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Racepinephrine HCl : Cardiovascular Cardiovascular side effects have included elevations of heart rate and blood pressure. In smaller doses, racepinephrine has caused peripheral coronary arterial vasodilation, but in larger doses, racepinephrine has caused diffuse vasoconstriction. This has caused increased peripheral vascular resistance, which was important in patients with coronary artery disease (worsened myocardial ischemia/angina) or hypertension (risk of emergent hypertension/stroke). Arrhythmias, including fatal ventricular fibrillation, have been reported in patients with underlying cardiac disease. Rapid rises in blood pressure have produced cerebral hemorrhage, particularly in elderly patients with cardiovascular disease. Angina may occur in patients with coronary artery disease. Gastrointestinal Gastrointestinal side effects have included nausea and vomiting. Nervous system Nervous system side effects have included fear, agitation, anxiety, tenseness, restlessness, headache, tremor, dizziness, lightheadedness, nervousness, sleeplessness, excitability, weakness, and increased parkinsonian tremors. Psychiatric Psychiatric side effects have included agitation, disorientation, impaired memory, aggressive or assautive behavior, hallucinations, and psychosis.

Mechanism of Action

Racemic epinephrine works by stimulation of the ?-adrenergic receptors in the airway with resultant tightening of the mucosa (mucosal vasoconstriction) and decreased fluid in the airway (subglottic edema) and by stimulation of the ?-adrenergic receptors causing relaxation of the bronchial smooth muscle.