Epinephrine

Question 1

Epinephrine

Class

Answer 1

Sympathomimetic

Question 2

Epinephrine

Action

Answer 2

Stimulates adrenergic receptors:
Alpha- peripheral vasoconstriction
Beta I- positive inotrope and chronotrope
Beta II- bronchodilation

Question 3

Epinephrine

Indication

Answer 3

No pulse:
Asystole
V-fib
V-tach
PEA
Idioventricular rhythm

With pulse:
Anaphylaxis
Bronchospasm (from respiratory distress)

Question 4

Epinephrine

Dose/route

Answer 4

Asthma: 0.3 mg - 0.5 mg 1:1000 IM, MR q 5min to max 2 doses.

Anaphylaxis: 0.3 mg - 0.5 mg 1:1000 IM, MR q 5-15 min as needed

Cardiac arrest: 1 mg 1:10,000 IVP, IO. MR q 3-5 min.

Drip: mix 1 mg in 250cc NS or D5W and start at 30 gtts/min
(Equivalent to 2mcg/min), titrate to affect

Question 5

Epinephrine

Peds dose

Answer 5

Asthma and anaphylaxis:
0.01 mg/kg 1:1,000 IM. MR q 5-15 min to max 0.3 mg

Cardiac arrest:
0.01 mg/kg (0.1 ml/kg) 1:10,000 IVP, IO. MR q 3-5 min.

Question 6

Epinephrine

Onset

Answer 6

IV/IO: less than 2 min

IM: 3-10 min

Question 7

Epinephrine

Contraindications

Answer 7

None in cardiac arrest
Underlying cardiovascular disease
Hypersensitivity to sympathomimetics
Tachyarrhythmias
Hypertension
Hemorrhagic or cardiogenic shock

Question 8

Epinephrine

Adverse effects

Answer 8

CNS: h/a, anxiety, skeletal muscle tremors
CV: hypertension, SVT, ventricular irritability, palpitations, MI

Question 9

Epinephrine

Precautions

Answer 9

Monitor V/S and EKG
Use supplemental o2
Potentiation may occur w/ sympathomimetics

Question 10

Epinephrine

Supplied

Answer 10

1: 10,000: 0.1 mg/ml in a 10ml preload
1: 1,000: 1.0 mg/ml in a 1 ml ampule or 30 ml vial