Epinephrine

Question 1

Classification:

Answer 1

• Adrenergic agent
• Inotropic

Question 2

Action:

Answer 2

• Binds strongly w/ both alpha and beta receptors, producing increased BP, increased HR, bronchodilation

Question 3

Indications:

Answer 3

• Bronchospasm
• Allergic and anaphylactic reactions
• Restoration of cardiac activity in cardiac arrest

Question 4

Adverse Effects:

Answer 4

• Anxiety
• Headache
• Cardiac arrhythmias
• HTN
• Nervousness
• Tremors
• Chest pain
• Nausea/ vomiting

Question 5

Contraindications:

Answer 5

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

Question 6

Dosage (Adult)
Cardiac Arrest:

Answer 6

• 1 mg (1:10,000 solution) IV, IO
• May repeat every 3-5 mins

Question 7

Dosage (Pediatric)
Cardiac Arrest:

Answer 7

• 0.01 mg/kg (1:10,000 solution) IV, IO
• Repeat every 3-5 mins as needed (Max dose: 1 mg)

Question 8

Dosage (Adult)
Symptomatic Bradycardia:

Answer 8

• 2 to 10 mcg/min (1:10,000 solution) as continuous IV infusion
• Usual dosage range: 2-10 mcg/min IV
• Titrate to effect

Question 9

Dosage (Pediatric)
Symptomatic Bradycardia:

Answer 9

• 0.01 mg/kg (1:10,000 solution) IV, IO
• May repeat every 3-5 mins (Max dose: 1 mg)
• If giving epinephrine by ET tube, administer 0.1 mg/kg

Question 10

Dosage (Adult)
Asthma Attacks and Certain Allergic Reactions:

Answer 10

• 0.3 to 0.5 mg (1:1000 solution) IM or subcutaneous
• May repeat every 10-15 mins (Max dose: 1 mg)

Question 11

Dosage (Pediatric)
Asthma Attacks and Certain Allergic Reactions:

Answer 11

• 0.01 mg/kg (1:1000 solution) IM or subcutaneous (Max dose: 0.5 mg)

Question 12

Dosage (Adult)
Anaphylactic Shock:

Answer 12

• 0.5 mg (1:1000 solution) IM repeated as needed every 5-15 mins
• Transition to IV infusion of 1-4 mcg/min titrated to effect

Question 13

Dosage (Pediatric)
Anaphylactic Shock:

Answer 13

• 0.01 mg/kg IM, repeat as needed every 5-15 mins
• Transition to continuous IV infusion rate of 0.1-1 mcg/kg/min (1:10,000 solution)
• Titrate to response

Question 14

Special Considerations:

Answer 14

• Half life of 1 minute