Epinephrine has various side effects, including those listed below: · Abnormal o

Question

Epinephrine has various side effects, including those listed below:

·         Abnormal or decreased touch sensation

·         arm, back, or jaw pain

·         bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

·         blurred vision

·         chest pain or discomfort

·         chest tightness or heaviness

·         dizziness

·         fainting

·         fast, irregular, pounding, or racing heartbeat or pulse

·         fear or nervousness

·         headache

·         nausea or vomiting

·         paleness of the skin

·         pounding in the ears

·         restlessness

·         shakiness in the legs, arms, hands, or feet

·         slow or fast heartbeat

·         stroke

·         sweating

·         trembling or shaking of the hands or feet

·         troubled breathing

·         unusual tiredness or weakness

How are these ‘side effects’ explained at the molecular level (not all have to be elaborated on)? Explain in terms of biochemistry.

Explanation / Answer

The important property of epinephrine is vasoconstriction (increases peripheral resistance). Epinephrine has positive ionotropic (increased rate of contraction) and positive chronotropic effects (increased force of contraction) on heart. It raises blood glucose levels and increase pupil size. Under normal conditions, the vasoconstrictor property of adrenaline is very helpful to maintain the mean arterial pressure.

However, increased vasoconstriction (decreased lumen) decrease the blood flow and increase the blood flow pressure. This causes decreased blood supply to some region say periphery, which causes numbness (in terms of altered touch sensation).

This also decreases the body temperature. Increased blood pressure increases cardiac output and load, which causes oxygen insufficiency. This oxygen insufficiency causes congestion in the chest region, and pain. Increased blood flow to the brain causes headache, which sometimes causes rupture of capillaries, causing stroke (this may also occur in heart). Heart works more in hypertensive people, heart muscles contract more forcefully that causes cardio-myopathy (heart enlargement). The walls of arterial muscle become more rigid and sometimes clots may form, which further obstruct the blood flow. All these factors cause obstruction to the blood flow, and gradually causes heart attack.

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