Epinephrine

Question 1

Epinephrine Trade Name

Answer 1

EpiPen, EpiPen Jr, Auvi-Q, Symjepi, Adrenalin

Question 2

Epinephrine Classification

Answer 2

Medscape: Alpha/Beta Adrenergic Agonists; Alpha/Beta Agonists

Capital: Sympathomimetic
(Sympathetic Agonist)

Question 3

Epinephrine Mechanism

Answer 3

Medscape:
Strong alpha-adrenergic effects, which cause an increase in cardio output and HR, a decrease in renal perfusion and PVR (post void residual) and a variable effect on BP, resulting in systemic vasoconstriction and increased vascular permeability

Strong beta1- and moderate beta2-adrenergic effects, resulting in bronchial smooth muscle relaxation

Secondary relaxation effect on smooth muscle of stomach, intestine, uterus, and urinary bladder

Question 4

Epinephrine Onset of Action

Answer 4

Medscape: 5-10 min (SC); 1 min (inhalation)

Question 5

Epinephrine Duration of Action

Answer 5

Medscape:
Duration: 4 hr

Question 6

Epinephrine Indications

Answer 6

CT Protocols:
Severe Asthma and COPD exacerbation. Anaphylaxis, Bradycardia refractory to atropine and/or TCP, Fluid refractory shock (Septic, anaphylactic, postresuscitative, cardiogenic), Stridor at rest (nebulized)

Capital:
Cardiac arrest, Anaphylaxis, Severe bronchospasm, Symptomatic bradycardia,
Non-hypovolemic shock

Question 7

Epinephrine Contraindications

Answer 7

CT Protocols:
Allergy

Capital:
None in cardiac arrest, Hypovolemia, Tachydysrhythmia, Relative: heart disease, tachycardia, hypertension

Question 8

Epinephrine Side Effects/ Precautions/ Comments

Answer 8

Capital:
Tachycardia, Hypertension, Increased myocardial oxygen demand, Dysrhythmia, Headache, Nausea/vomiting, Syncope

Question 9

Epinephrine Adult Dose

Answer 9

CT Protocols:
Allergic Reaction/Anaphylaxis
0.3 mg 1:1,000 IM; May repeat every 5 minutes until signs & symptoms resolve.

Refractory Anaphylaxis/Septic Shock/Bradycardia/Post-
Resuscitative Care
* Epinephrine infusion 2-10 micrograms/minute. 1:1,000

Asthma/COPD/RAD
* 0.3 mg 1:1,000 IM
Smoke Inhalation & Airway Management – stridor at rest
5 mg nebulized (no repeat).

Cardiac arrest: 1 mg 1:10,000 IV/IO every 3-5 minutes

Question 10

Epinephrine Pediatric Dose

Answer 10

Capital:
Cardiac arrest: 0.01 mg/kg (0.1ml/kg) 1:10,000 IV/IO every 3-5 minutes

Anaphylaxis/severe bronchospasm: 0.01 mg/kg 1:1,000 IM

Shock/bradycardia: 0.1-1.0 mcg/kg/min IV/IO infusion

Question 11

Epinephrine
Max Dose Adult (Pediatric)

Answer 11

??

Question 12

Epinephrine Routes of Administration

Answer 12

IV/IO/IM

Question 13

Epinephrine How Supplied

Answer 13

1 mg/ml vials and ampules (1: 1,000)
1 mg/10ml prefilled syringes (1: 10,000)