Therapeutic Use of Epinephrine

The sympathetic nervous system has an organ-specific distribution of adrenoceptor subtypes and there are many prescription drugs that modulate their activities. For example, β1-adrenoceptor antagonists, such as metoprolol, can selectively decrease heart rate and contractility; while β2-adrenoceptor agonists, such as albuterol, can selectively dilate bronchioles.15,16 Other sympathetic agonists/antagonists are used to treat gastrointestinal and genitourinary problems.16

Here, further discussion is limited to the therapeutic uses of epinephrine in auto-injectors to treat anaphylaxis and the use of epinephrine and levonordefrine adjuvants in some LA formulations intended to decrease LA’s rate of vascular absorption, thereby, localizing and prolonging LA’s duration of action and, potentially, reducing LA’s systemic toxicity; and, with infiltration anesthesia, to control superficial bleeding from arterioles and capillaries.4