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Medicines > generic : 25I-NBOH or Codeine or Epinephrine (adrenaline)

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generic: (Click arrow to add another value)
brand:
None (2) · (multiple, generic dominant) (1) · EpiPen, EpiPen Jr, Auvi-Q, Adrenaclick, Symjepi; many generic (1)
classes:
Analgesic (2) · Classic Psychedelic (1) · Opioid (2) · Phenethylamine (1) · Prodrug (1) · Research material (1) · [[:Category:Catecholamines|Catecholamine]] (1) · [[:Category:Inotropes|Inotrope]] (1) · [[:Category:Sympathomimetics|Sympathomimetic]] (1) · [[:Category:Vasopressors|Vasopressor]] (1)
mechanism:
Mu-opioid receptor agonist; prodrug (metabolized to morphine) (1) · Potent 5-HT2A agonist (1) · Prodrug; converted to [[Morphine|morphine]] by [[Enzyme:CYP2D6|CYP2D6]] for analgesic action. (1) · '"`UNIQ--vote-00000E4A-QINU`"' The narrow safe-bolus window for IV use (sharp risk of arrhythmia, hypertensive emergency, intracerebral hemorrhage) is why anaphylaxis dosing is '''IM, not IV''', outside critical care'"`UNIQ--ref-00000E4B-QINU`"'. (1)
uses:
None (2) · Mild to moderate pain; cough suppression (low-dose). (1) · '"`UNIQ--vote-00000E4C-QINU`"', '"`UNIQ--vote-00000E4D-QINU`"', '"`UNIQ--vote-00000E4E-QINU`"', '"`UNIQ--vote-00000E4F-QINU`"', '"`UNIQ--vote-00000E50-QINU`"', '"`UNIQ--vote-00000E51-QINU`"' (1)
starting dose:
None (2) · Adult: 15–60 mg every 4 hours as needed. (1) · Anaphylaxis IM 0.3-0.5 mg (adult) into lateral thigh, repeat q5-15 minutes prn; pediatric 0.01 mg/kg IM (max 0.3 mg, max 0.5 mg in adolescents); cardiac arrest 1 mg IV/IO q3-5 minutes; severe asthma neb 0.1 mg/kg up to 5 mg; never IV bolus for anaphylaxis outside critical care (1)
preparations:
None (2) · Auto-injectors 0.15 mg (Jr/pediatric), 0.3 mg (adult); 1 mg/mL (1:1,000) ampules for IM/SC use; 0.1 mg/mL (1:10,000) for IV use; 2.25% racemic nebulizer (1) · Tablet (15, 30, 60 mg); oral solution; combination products (with [[Acetaminophen|acetaminophen]] or ibuprofen). (1)
fda max:
None (2) · 360 mg/day (1) · Indication-specific; ACLS no fixed cumulative ceiling (1)
routes:
None (2) · endotracheal (legacy ACLS (1) · IM (1) · intracardiac (historical only) (1) · IV (1) · nebulized (1) · not preferred) (1) · PO (only formulation marketed in the US). (1) · SC (less common) (1)
onset:
None (2) · 30–60 min (PO) (1) · IM: 5-10 minutes; IV: seconds; nebulized: 5-10 minutes (1)
duration:
None (2) · 4–6 hours (1) · 5-15 minutes (1)
halflife:
None (2) · 2.5–3 hours (1) · ~2 minutes'"`UNIQ--ref-00000E52-QINU`"' (1)
bioavailability:
None (2) · IM/SC ~100%; oral negligible (extensive first-pass and gut metabolism — hence the no-oral route)'"`UNIQ--ref-00000E53-QINU`"' (1) · ~50% (variable, CYP2D6-dependent for analgesic effect). (1)
pregnancy:
None (2) · Avoid; risk of neonatal opioid withdrawal with chronic use; UM-mother breastfeeding contraindicated. (1) · Used in life-threatening obstetric anaphylaxis without hesitation; benefits clearly outweigh.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
None (2) · US Schedule II (single-entity); Schedule III–V (combination products by content). (1) · [[USLegal:Prescription only|Rx-only]] in US (1)

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