**16. Epinephrine use**

Racemic adrenaline is a sympathomimetic drug used in Paediatric bronchiolitis and severe upper respiratory tract obstructions. Although this treatment has been used safely for many years, there is a need for heart rate and ECG monitorisation in cases administered epinephrine consecutively [55]. It has been reported that MI has developed associated with epinephrine not only in cases with racemic epinephrine but also in cases where epinephrine has been used when applying cardiopulmonary resuscitation [56]. The coronary vasospasm of epinephrine is made over alpha 1 and alpha 2 receptors. While low-dose adrenaline shows a beta mimetic effect, at high doses the effect is seen by vasoconstriction, primarily over the alpha 1 and alpha 2 receptors. As there is a relationship between epinephrine used intravenously and a higher complication rate, the selection of intramuscular or subcutaneous routes could contribute greatly to reducing the cardiovascular risks [56] Vasodilators such as nitrate and calcium channel blockers are selected in MI cases related to epinephrine [57, 58].
