Intravenous epinephrine abuse

Am J Emerg Med. 1987 Jan;5(1):64-5. doi: 10.1016/0735-6757(87)90293-2.


A 19-year-old man with a history of intravenous cocaine and amphetamine abuse injected 1.1 mg of epinephrine intravenously from an over-the-counter bronchodilator inhaler. Within seconds, headache, nausea, numbness of hands and feet, precordial chest discomfort, and palpitations developed. The patient was given a sublingual nitroglycerin tablet by a bystander and promptly had a syncopal episode. Hypotension was observed in the emergency department 10 minutes later. Administration of 2 L of Ringer's lactate maintained blood pressure at 80-90 mm Hg systolic. An electrocardiogram showed ischemic changes in the precordial leads. Cardiac enzymes remained normal. Mild hypokalemia and hyperglycemia were observed. This case illustrates an unusual route of abuse of an over-the-counter epinephrine bronchodilator.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bronchodilator Agents*
  • Epinephrine*
  • Humans
  • Male
  • Nonprescription Drugs*
  • Substance-Related Disorders*


  • Bronchodilator Agents
  • Nonprescription Drugs
  • Epinephrine