Epinephrine

Question 1

Epinephrine Class

Answer 1

Antidysrhythmic, Bronchodilator, Catecholamine, Inotropic Agent, Sympathomimetic, Vasopressor

Question 2

Epinephrine Action

Answer 2

Directly stimulates alpha-1, beta-1 and beta-2 adrenergic receptors (nerve cells that epi acts as a neurotransmitter). Effects on the heart - increased contractility force, increased rate and increased cardiac output (the amount of blood the heart pumps through the circuitry system in a minute). Epinephrine is also a vasoconstrictor and bronchodilator. Also slows gastric motility, miosis (pupil construction) and pale skin.

Question 3

Epinephrine Indications

Answer 3

• Cardiac Arrest
• Anaphylaxis or severe allergic reaction
• severe reactive airway disease (asthma, COPD)
• Hypotension with symptomatic bradycardia

Question 4

Epinephrine Contraindications

Answer 4

Hypovolemic Shock, None in the emergency setting

Question 5

Epinephrine Adult dose - Cardiac Arrest:

Answer 5

1 mg (1:10,000) (0.1 mg/mL) IV/IO; every 3–5 minutes

Question 6

Epinephrine Adult Dose - anaphylaxis, refractory asthma

Answer 6

0.3 mg IM adult autoinjector (preferred) or 0.3 mg IM (1:1,000) (1 mg/mL) every 5–15 minutes

Question 7

Epinephrine Adult dose - profound bradycardia or hypotension:

Answer 7

2–10 mcg/min titrated to effect (mix 1 mg for every 100 mL NaCl)

Question 8

Epinephrine Adult Dose - laryngotracheobronchitis (croup):

Answer 8

3 mg (1:1,000) (1 mg/mL) in 3 mL NaCl via nebulizer every 5–15 min

Question 9

Epinephrine Pedi Dose - Cardiac arrest and symptomatic bradycardia:

Answer 9

0.01 mg/kg (1:10,000) (0.1 mg/mL) IV/IO every 3–5 minutes

Question 10

Epinephrine Pedi Dose - anaphylaxis, refractory asthma, or asthma with impending respiratory failure: (autoinjector preferred)

Answer 10

0.15 mg IM pediatric autoinjector for patient under 25 kg 0.3 mg IM pediatric autoinjector for patient over 25 kg or 0.01 mg/kg IM (1:1,000) (1 mg/mL) every 5–15 minutes

Question 11

Epinephrine Pedi Dose - profound bradycardia or hypotension:

Answer 11

0.1–1 mcg/kg/min titrated to effect (mix 1 mg for every 100 mL NaCl)

Question 12

Epinephrine Pedi Dose - laryngotracheobronchitis (croup):

Answer 12

3 mg (1:1,000) (1 mg/mL) in 3 mL NaCl via nebulizer every 5–15 min

Question 13

Epinephrine Side Effects

Answer 13

Anxiety, Dysrhythmias, Hypertension, Palpitations, Tachycardia, Tremors

Question 14

Epinephrine Onset

Answer 14

Immediate