Epinephrine 1:1000 & 1:10,000 (Adrenalin)

Question 1

Classification

Answer 1

Sympathomimetic, adrenergic agent, inotropic

Question 2

Mechanism of Action

Answer 2

• Binds strongly with both alpha & beta receptors
• Increases heart rate & automaticity
• Increases cardiac contractile force
• Increases myocardial electrical activity
• Increases systemic vascular resistance
• Increases blood pressure
• Bronchodilation

Question 3

Indications

Answer 3

• Bronchial Asthma
• Exacerbation of COPD
• Allergic reactions & anaphylaxis
• Restoration of cardiac activity in cardiac arrest

Question 4

Contraindications

Answer 4

• Arrythmias other than VF, asystole, or PEA
• Cardiovascular disease
• Hypertension
• Cerebrovascular disease
• Shock, secondary to causes other than anaphylactic shock
• Closed angle glaucoma
• Diabetes
• Pregnant women in active labor
• Known hypersensitivity to epinephrine or sulfites

Question 5

Adverse Effects

Answer 5

• Palpitations, tachycardia, anxiousness, headache, tremor, chest pain

Question 6

Administration

Answer 6

• Cardiac Arrest
  
  • Adult: 1 mg (1:10,000) IV/IO, repeat Q3-5 minutes.
  • Pediatrics: 0.01 mg/kg (1:10,000) IV/IO, repeat Q3-5 minutes, max dose 1 mg.
• Symptomatic Bradycardia
  
  • ​Adult: 1 mcg/min (1:10,000) as continous IV infusion; usual dose range 2-10 mcg/min IV, titrate to effect.
  • Pediatric: 0.01 mg/kg (1:10,000) IV/IO, repeat Q3-5 minutes, max dose 1 mg.
• Asthma Attacks & Certain Allergic Reactions
  
  • Adult: 0.3-0.5 mg (1:1,000) IM or SubQ, may repeat every 10-15 minutes. max dose 1 mg
  • Pediatrics: 0.01 mg/kg (1:1,000) IM/SubQ, max dose 0.5 mg
• Anaphylactic Shock​
  
  • Adult: 0.1 mg (1:10,000) IV slowly over 5 minutes or IV infusion of 1-4 mcg/min, titrate to effect.
  • Pediatrics: Continous IV infusion rate of 0.1-1 mcg/kg/min (1:10,000), titrate to effect.

Question 7

Special Considerations

Answer 7

• Half life is one minute