Epinephrine

Information from Drugs.com, provided by Vetone:

Epinephrine 1:1000 Caution

Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Composition

Each mL of sterile aqueous solution contains:

Disodium Edetate, Sodium Metabisulfite, Hydrochloric Acid, and Water for Injection.

Storage

Store at controlled room temperature between 15° and 30°C (59°-86°F).

Protect from light and heat. DO NOT FREEZE.

Epinephrine 1:1000 Indications

For emergency use only in treating anaphylactoid shock in sheep, swine, cattle, horses, dogs and cats.

Dosage and Administration

Dogs and Cats: 0.1 to 0.5 mL injected Intramuscularly or Subcutaneously.

Cattle, Horses, Sheep and Swine: 1 mL per 100 lbs of body weight injected Intramuscularly or Subcutaneously.

Warning

Do not use this product if its color is pinkish or darker than slightly yellow or if it contains a precipitate.

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Information from VetCoach:

• Used for: Anaphylaxis, cardiac resuscitation
• Brands: Epipen, Adrenaline
• Species: Dogs and cats and other animals
• Drug type: Anti-cholenergic
• Prescription required: Yes
• Pregnancy and lactation: Should not be used in pregnant animals, safe use is not established in nursing neonates
• Side effects: Anxiety, tremors, excitability, vomiting, hypertension, arrhythmias, hyperuricemia, lactic acidosis
• FDA approved: Yes

Information from Plumb's Veterinary Drug Handbook, 7th Edition, by Donald C. Plumb:

Epinephrine is contraindicated in patients with narrow-angle glaucoma, hypersensitivity to epinephrine, chock due to non-anaphylactois causes, during general anesthesia with halogenated hydrocarbons or cyclopropane, during labor (may delay the second stage), and cardiac dilation or coronary insufficiency. Epinephrine also should not be used in cases where vasopressor drugs are contraindicated (e.g. thyrotoxicosis, diabetes, hypertension, toxemia of pregnancy). It should not be injected with local anesthetics into small appendages (e.d. toes, ears, etc) because of the chance of necrosis and sloughing. 

Use epinephrine with caution in cases of hypovolemia it is not a substitute for adequate fluid replacement therapy. It should be usedwith extreme caution in patients with a prefibrillatory cardiac rhythm, because of its Excitatory effects on the heart. While epinephrine's usefulness in asystole is well documented, it can cause ventricular fibrillation; use cautiously in cases of ventricular fibrillation.

Epinephrine can induce adverse effects such as feelings of fear or anxiety, tremor, excitability, vomiting, hypertenaion (overdosage), arrhythmias (especially is patet has organic heart disease or has received another drug that sensitizes the heart to arrhythmias), hyperuricemia, and lactic acidosis (prolonged use or overdose). Repeated injections can cause necrosis at the injection site.

Insufficient studies have been made to comment on use during pregnancy. It is not know if this drug is excreted in milk. 

Clinical signs seen with overdosage or inadvertent IV administration of SC or IM dosages can include sharp rises in systolic, diastolic, and venous blood pressure, cardiac arrhythmias, pulmonary edema and dyspnea, vomiting, headache, and chest pain. Cerebral hemorrhages may result because of the increased blood pressures. Renal failure, metabolic acidosis, and cold skin may also result.Because epinephrine has a relatively short duration of effect, treatment is mainly supportive. If necessary, the use of an alpha adrenergic blocker (e.g. phentolamine) or a beta adrenergic blocker (e.g.g propanolol) can be considered to treat severe hypertension and cardiac arrythmias. Prolonged periods of hypotension may follow, which may require treatment with norepinephrine. 

The following drugs may interact with epinephrine: alpha blockers, alpha-2 agonists, general anesthetics, antihistamines, beta blockers, digoxin, nitrates, levothyroxine, oxytocic agents, sympathomimetic agents, phenothiazines, reserpine, tricyclic antidepressants.