Epi (adult) & Diphenhydramine

Question 1

Epinephrine Trade Name

Answer 1

Adrenalin®

Question 2

Epinephrine Class

Answer 2

Sympathomimetic

Question 3

Epinephrine Standard Supplies

Answer 3

-Prefilled syringe
-Vial
-Ampule
-Auto-injectors
o Adult EpiPen®
o EpiPen Jr.®

Question 4

Epinephrine MOA:

Answer 4

-Alpha-adrenergic response
o Vasoconstriction
-Beta1-adrenergic responses
o Increases the heart rate
o Increases myocardial
contractility
-Beta2-adrenergic response
o Relaxes bronchial smooth
muscle resulting in
bronchodilation
-Blocks histamine receptors

Question 5

Epinephrine Indications

Answer 5

Cardiac arrest
o Asystole
o Pulseless electrical activity
o Ventricular fibrillation
o Pulseless ventricular
tachycardia
-Hemodynamically significant hypotension from a cause other than hypovolemia
-Asthma
-Bronchospasm associated with chronic bronchitis and emphysema

Question 6

Epinephrine Indications cont.

Answer 6

-Allergic reaction
o Anaphylaxis
o Hemodynamically significant
bradycardia

Question 7

Epinephrine Contraindication

Answer 7

None in emergency setting

Question 8

Epinephrine S/E:

Answer 8

-Extravasation of the IV/IO may cause tissue necrosis
-Tachycardia
-Increased myocardial oxygen demand
-Hypertension
-Dysrhythmias
-Dyspnea
-Palpitations
-Chest pain
-Nervousness
-Anxiety
-Dizziness
-Headache
-Tremors
-Nausea, vomiting

Question 9

Epinephrine Routes:

Answer 9

IV, IO, IM, ET, Infusion

Question 10

Epinephrine Onset

Answer 10

Immediate

Question 11

Epinephrine Adult dosages:

Answer 11

-Cardiac arrest: 1.0 mg (1:10,000) IV/IO
o May repeat the dosage
every 3 to 5 minutes during
resuscitation
-Cardiac arrest: 2.0 to 2.5 mg (1:1,000) ET diluted in 10 mL normal saline
o May repeat the dosage
every 3 to 5 minutes during
resuscitation
-Hemodynamically significant bradycardia: 2.0 to 10 mcg/minute infusion
-Hemodynamically significant hypotension: 2.0 to 10 mcg/minute infusion

Question 12

Epinephrine Adult dosages (cont.) :

Answer 12

-Bronchospasm associated with chronic bronchitis and emphysema/allergic
reaction/anaphylaxis: 0.3 to 0.5 mg (1:1,000) IM
o Adult EpiPen® auto-
injector 0.3 mg IM

Question 13

Diphenhydramine Trade name

Answer 13

Benadryl®

Question 14

Diphenhydramine Classes:

Answer 14

-Antihistamine
-Anticholinergic

Question 15

Diphenhydramine Standard supplies:

Answer 15

-Vial
-Prefilled syringe

Question 16

Diphenhydramine MOA:

Answer 16

-Blocks H1 histamine receptors
-Reverses phenothiazine reaction with extrapyramidal symptoms

Question 17

Diphenhydramine Indications:

Answer 17

-Allergic reaction
-Anaphylaxis
-Phenothiazine reaction with extrapyramidal symptoms

Question 18

Diphenhydramine Contraindication

Answer 18

Hypersensitivity

Question 19

Diphenhydramine S/E:

Answer 19

-Hypotension
-Dysrhythmias
-Sedation
-Euphoria
-Dizziness
-Headache
-Blurred vision
-Palpitations

Question 20

Diphenhydramine Routes:

Answer 20

-IV
-IO
-IM

Question 21

Diphenhydramine Onset:

Answer 21

15-30 minutes

Question 22

Diphenhydramine Adult dosages:

Answer 22

-Allergic reaction/anaphylaxis: 25 to 50 mg
-Phenothiazine reaction with extrapyramidal symptoms: 10 to 50 mg

Question 23

Diphenhydramine PEDS dosages:

Answer 23

1.0 - 1.25 mg/kg