Epinephrine

Question 1

Epinephrine 1:10,000 (Adrenalin)

Class

Answer 1

Sympathomimetic

Question 2

Epinephrine 1:10,000 (Adrenalin)
Mechanism of Action
Alpha Agonist Action

Answer 2

Alpha: vasoconstriction.

Question 3

Epinephrine 1:10,000 (Adrenalin)

Indications

Answer 3

Cardiac arrest (V-fib/pulseless V-tach, Asystole, PEA)

Anaphylaxis.

Should not be used for patients who do not require extensive resuscitative efforts.

Question 4

Epinephrine 1:10,000 (Adrenalin)

Contraindications

Answer 4

Hypothermia

pulmonary edema

myocardial ischemia

hypovolemic shock

Question 5

Epinephrine 1:10,000 (Adrenalin)

Relative Contraindications

Answer 5

Underlying cardiovascular disease/angina, hypertension

pregnancy

patients over 40 years of age

hyperthyroidism

Question 6

Epinephrine 1:10,000 (Adrenalin)

Adverse Reactions

Answer 6

Hypertension, tachycardia, arrhythmia

pulmonary edema, anxiety, restlessness,

psychomotor agitation, nausea, headache, and angina.

Question 7

Epinephrine 1:10,000 (Adrenalin)

Drug Interactions

Answer 7

Potentiates other sympathomimetics

deactivated by alkaline solutions, (i.e. Sodium bicarbonate)

monoamine oxidase inhibitors (MAOIs) may potentiate effects

beta-blockers may blunt effects.

Question 8

Epinephrine 1:10,000 (Adrenalin)
Adult
Cardiac Arrest IV/ IO

Answer 8

1 mg (10 mL of 1:10,000 solution) every 3 – 5 minutes during resuscitation.

Follow each dose with 20 mL flush and evaluate arm for 10 – 20 seconds after dose.

Higher doses (up to 0.2 mg/kg) may be administered for specific conditions (beta-blocker and calcium channel- blocker overdose).

Question 9

Epinephrine 1:10,000 (Adrenalin)

Continuous Infusion

Answer 9

Add 1 mg (1 mL of 1:1,000 solution) to 500 mL of NS or D5W.

Initial infusion rate of 1 mcg/min titrated to effect (typical dose 2 – 10 mcg/min)

Question 10

Epinephrine 1:10,000 (Adrenalin)

Profound Hypotension

Answer 10

2 – 10 mcg/min; titrate to patient response.

Question 11

Epinephrine 1:10,000 (Adrenalin)
Pediatric
Cardiac Arrest
IV/ IO

Answer 11

0.01 mg/kg (0.01 mL/kg) of 1:10,000 solution every 3 – 5 minutes during arrest.

Question 12

Epinephrine 1:10,000 (Adrenalin)

Onset

Answer 12

immediate with peak effects in minutes.

Question 13

Epinephrine 1:10,000 (Adrenalin)

Duration

Answer 13

Several Minutes

Question 14

Epinephrine 1:10,000 (Adrenalin)

Special Considerations

Answer 14

May cause syncope in asthmatic children.

May increase myocardial oxygen demand.

Question 15

Epinephrine 1:10,000 (Adrenalin)
Mechanism of Action
Beta 1 Agonist

Answer 15

Beta-1: positive inotropic, chronotropic, and dromotropic effects.

Question 16

Epinephrine 1:10,000 (Adrenalin)
Mechanism of Action
Beta 2 Agonist

Answer 16

Beta-2: bronchial smooth muscle relaxation and dilation of skeletal vasculature.