Epinephrine

Question 1

Epinephrine: Class

Answer 1

Catcecholamine: Sympathomimetic (Alpha and Beta effects)

Question 2

Epinephrine: Action

Answer 2

• On Bronchi: Bronchodilation (beta-2)
• On Peripheral Vasculatlure: Vasconstriction (alpha)
• On heart:
  
  • increased heart rate (beta-1) / chronotropic
  • increased AV conduction / dromotropic
  • increased automaticity / dromotropic

Question 3

Epinephrine: Onset/Duration

Answer 3

Onset: IV/IO = 1-2 minutes
IM = 5-10 min.

Duration: IV/IO = 5-10 minutes
IM = 1-4 hours

Question 4

Epinephrine: Indications

Answer 4

Allergic Reaction / Anaphylaxis (angioedema)

Respiratory Distress
- severe RD … or inadequate response to albuterol/atrovent

PEDS: Respiratory Distress
- with STRIDOR at rest

PEDS: Burns
- Respiratory distress with Stridor

Dysrhythmias
- Cardiac Arrest (pulseless cpr patient)

PEDS Dysrhythmias
- Unstable Bradycardia: after BVM for 30 seconds

PEDS, Newborn Deliveries
- if HR remains < 60 after 30 seconds of CPR

Question 5

Epinephrine: Dosage/Route

For Allergic Reaction/Anaphylaxis

Answer 5

Adult:

0. 3mg IM 1:1,000 MR x2 q 5”
1. 1mg IV/IO 1:10,000 BHO; MR x2 q 3-5 BHO

PEDS
PDC IM 1:1,000 MR x2 q 5”
PDC. IV/IO 1:10,000 BHO; MR x2 q 3-5” BHO

Question 6

Epinephrine: Dosage/Route

For Respiratory Distress
- severe; or inadequate response to Albuterol/Atrovent

Answer 6

Adult:
0.3mg IM 1:1,000 MR x2 q 5”
If no definite history of asthma:
Dosing as above per BHO

PEDS:
PDC IM 1:1,000 MR x2 q 3-5”

Question 7

Epinephrine: Dosage/Route

For PEDS: Respiratory Distress
- with stridor at rest

Answer 7

PDC 1:1,000 via nebulizer MR x1

Question 8

Epinephrine: Dosage/Route

PEDS: Burns
- respiratory distress with Stridor

Answer 8

PEDS:

- 1:1,000  PDC via nebulizer. MR x1  SO
- 1:1,000. PDC IM  SO;   MR x2 q 5”  SO

Question 9

Epinephrine: Dosage/Route for…

Adult cardiac arrest
And
PEDS: unstable Brady

Answer 9

Adult:
- 1mg IV/IO 1:10,000 MR q 3-5”

PEDS

- ** After BVM for 30 seconds...
- PDC IV/IO  1:10,000. MR x2 q 3-5”;   MR q 3-5” BHO

Question 10

Epinephrine: Dosage/Route for

PEDS Newborn Deliveries

Answer 10

PEDS:

• • if HR remains < 60 after 30 seconds of CPR:
    
    • PDC IV/IO 1:10,000; MR x2 q 3-5”; MR q 3-5” BHO

Question 11

Epinephrine: Contraindications

Answer 11

None

Question 12

Epinephrine: side effects

Answer 12

• Anxiety/restlessness
• Palpitations/tachyarrhythmias
• Ventricular irritability
• Increased myocardial 02 demands
• Hypertension
• Angina

Question 13

Epinephrine: Packaging

Answer 13

1: 10,000 = 1mg/10ml. (Preload)
1: 1,000 = 1mg/1ml. (Vial)