EPI 1:10,000

Question 1

Epi 1:10,000

Class

Answer 1

Sympathomimetic

Question 2

Epi 1:10,000

Mechanism of Action

Answer 2

Direct-acting alpha- and beta-agonist. Alpha: vasoconstriction. Beta-1: positive inotropic, chronotropic, and dromotropic effects. Beta-2: bronchial smooth muscle relaxation and dilation of skeletal vasculature.

Question 3

Epi 1:10,000

Indications

Answer 3

Cardiac arrest (V-fib/pulseless V-tach, Asystole, PEA), anaphylaxis. Should not be used for patients who do not require extensive resuscitative efforts.

Question 4

Epi 1:10,000

Contraindications

Answer 4

Hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock

Question 5

Epi 1:10,000

Relative Contraindications

Answer 5

Underlying cardiovascular disease/angina, hypertension, pregnancy, patients over 40 years of age, hyperthyroidism

Question 6

Epi 1:10,000

Adverse Reactions

Answer 6

Hypertension, tachycardia, arrhythmias, pulmonary edema, anxiety, restlessness, psychomotor agitation, nausea, headache, and angina.

Question 7

Epi 1:10,000

Drug Interactions

Answer 7

Potentiates other sympathomimetics, deactivated by alkaline solutions, (i.e. Sodium bicarbonate), monoamine oxidase inhibitors (MAOIs) may potentiate effects, beta-blockers may blunt effects.

Question 8

Epi 1:10,000
Cardiac Arrest
IV/ IO Dose

Answer 8

1 mg (10 mL of 1:10,000 solution) every 3 – 5 minutes during resuscitation. Follow each dose with 20 mL flush and evaluate arm for 10 – 20 seconds after dose. Higher doses (up to 0.2 mg/kg) may be administered for specific conditions (beta-blocker and calcium channel- blocker overdose).

Question 9

Epi 1:10,000

ET Dose for Cardiac Arrest

Answer 9

2 – 2.5 mg diluted in 10 mL normal saline

Question 10

Epi 1:10,000

Continuous Infusion

Answer 10

Add 1 mg (1 mL of 1:1,000 solution) to 500 mL of NS or D5W. Initial infusion rate of 1 mcg/min titrated to effect (typical dose 2 – 10 mcg/min).

Question 11

Epi 1:10,000

Profound Bradycardia or Hypotension

Answer 11

2 – 10 mcg/min; titrate to patient response.

Question 12

Epi 1:10,000
Pediatric
Cardiac Arrest IV/ IO dose

Answer 12

0.01 mg/kg (0.01 mL/kg) of 1:10,000 solution every 3 – 5 minutes during arrest.

Question 13

Epi 1:10,000

Onset

Answer 13

immediate with peak effects in minutes.

Question 14

Epi 1:10,000

Duration

Answer 14

several minutes

Question 15

Epi 1:10,000

Special Considerations

Answer 15

May cause syncope in asthmatic children. May increase myocardial oxygen demand.