Epinephrine Flashcards
What is Epinephrine’s trade name?
Adrenaline
What drug class is Epinephrine?
Sympathomimetic
What is Epinephrine’s mechanism of action?
- Increase HR and automaticity by acting on the receptors associated with the SA and AV nodes and His-Purkinje system
- increase cardiac contractile force (acts on receptors in atria and ventricles)
- increase myocardial electrical activity
- increase systemic vascular resistance by acting on smooth muscles of the vessels
- increase BP by acting on smooth muscle vessels
- causes bronchodilation by acting on smooth muscles of the airway
What receptors for Epinephrine stimulate?
- alpha
- beta-1
- beta-2 adrenergic receptors
What are the indications for Epinephrine?
- anaphylaxis
- cardiac arrest
- pEA
- VF and pulseless VT
- symptomatic bradycardia
- hypotension accompanied by bradycardia,
reactive airway disease (Asthma, COPD)
Contraindications for Epinephrine
- hypersensitivity
- hypovolemic shock
- diluted cardiomyopathy
Adverse reactions to Epinephrine
- palpitations
- tachycardia
- anxiety
- headache
- tremor
- nausea and vomiting
What concentrations for Epinephrine come in?
1:1,000 (IM) and 1:10,000 (IV)
What is the IM dose for adults?
0.3-0.5mg
What is the IM dose for pediatrics?
0.01mg/kg (or 0.1mL/kg) up to 1mg total
What is the IV dose for adults?
1mg repeated every 3-5 minutes
What is the adult dose via IV for severe anaphylaxis?
0.05-0.1mg
What is the pediatric dose via IV for pediatrics?
0.01mg/kg initially every 3-5min
Special considerations for Epinephrine
- do not use pre-filled syringes
- syncope has occurred following epi administration to asthmatic children
- may increase myocardial oxygen demand
- should be protected from light
- pregnancy category C