Epinephrine

Question 1

Epinephrine: Class

Answer 1

Sympathomimetic

Question 2

Epinephrine: Mechanism of Action

Answer 2

• Direct acting alpha and beta agonist
• Alpha: bronchial, cutaneous, renal and visceral arteriolar vasoconstriction.
• Beta 1: positive inotropic and chronotropic actions, increases automaticity.
• Beta 2: bronchial smooth muscle relaxation and dilation of skeletal vasculature
• Blocks histamine release.

Question 3

Epinephrine: Indications

Answer 3

• Cardiac arrest
• Asystole
• PEA
• VF unresponsive to initial defibrillation
• Severe bronchospasm
• Asthma
• Bronchiolitis
• Anaphylaxis, acute allergic reactions.

Question 4

Epinephrine: Adult Dose

Answer 4

• Allergic reactions and asthma: 0.3 - 0.5 mg (0.3 - 0.5 ml 1:1000) IM
• Anaphylaxis: 0.3 - 0.5 mg (3- 5 ml 1:10,000) IV
• Cardiac: (asystole, PEA, VF) 1 mg IV push (1:10,000) every 3- 5 minutes
• Epinephrine Infusion: 2-10 mcg/minute

Question 5

Epinephrine: Pediatric Dose

Answer 5

• Allergic reactions and asthma: 0.01 mg/kg (0.01 mL/kg 1:1000) IM to maximum of 0.5 mg.
• Cardiac: (asystole, PEA, VF) IV, IO: Standard initial dose: 0.01 mg/kg (1:10,000, 0.1mL/kg)
• Epinephrine Infusion: Administer 0.1-1 mcg/kg/min IV or IO.
• Severe croup: 5 mg. as 5 ml. of 1:1000 solution administered via nebulization; may repeat every 30 minutes.
• Racemic epinephrine 11.25mg via nebulization