Epinephrine (Adrenalin)

Question 1

Epinephrine Class?

Answer 1

Sympathomimetic

Question 2

Epinephrine Action?

Answer 2

Endogenous catecholamine that directly stimulates both alpha-1, beta-1 and beta-2
adrenergic receptors. The effects this will have on the heart include increased contractile force,
increased rate, and increased cardiac output. Epinephrine is also a potent vasoconstrictor as
well as a bronchodilator. Other effects include slowing of gastric motility, miosis, and pale skin.

Question 3

Epinephrine Indications?

Answer 3

Anaphylaxis, cardiac arrest, asthma, bradycardia (first line in peds), shock not
caused by hypovolemia, severe hypotension accompanied with bradycardia when pacing and
atropine fail.

Question 4

Epinephrine Contraindications?

Answer 4

Hypovolemic shock. Caution should be used in patients with known
cardiovascular disease or pts > 45 y/o

Question 5

Epinephrine Onset/Duration?

Answer 5

Onset: 1-2 min IV, 5-10 mins SQ
Duration: 5-10 min IM

Question 6

Epinephrine Dose/Route?

Answer 6

Adult: Cardiac arrest – 1 mg 1:10,000 IV/IO every 3-5 min with no max.
Anaphylaxis/asthma – 0.3-0.5 mg SQ/IM 1:1,000. If no response, some protocols give
0.3-0.5 mg IV 1:10,000. Post cardiac arrest or for bradycardia with severe hypotension –
2-10 mcg/min IV drip and titrate to effect.

Peds: Cardiac arrest – 0.01 mg/kg 1:10,000 IV/IO max of 1 mg every 3-5 mins.
Anaphylaxis/asthma – 0.01 mg/kg 1:1,000 SQ/IM with a max single dose 0.3 mg.

Question 7

Epinephrine Side Effects?

Answer 7

Tachycardia, hypertension, anxiety, cardiac dysrhythmias, tremors, dyspnea

Question 8

Epinephrine Note*

Answer 8

Always use epinephrine 1:1,000 when given SQ/IM and 1:10,000 when given IV/IO.
Giving concurrently with alkaline solutions such as sodium bicarbonate will cause crystallization
of fluid.