EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Question 1

Generic/Trade Name

EPINEPHRINE

Answer 1

Adrenalin®, EpiPen®, EpiPen® Jr.

Question 2

Generic/Trade Name

Adrenalin®, EpiPen®, EpiPen® Jr.

Answer 2

EPINEPHRINE

Question 3

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Drug Classification:

Answer 3

• Sympathomimetic
• Sympathetic agonist
• Catecholamine

Question 4

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Mechanism of Action:

Answer 4

• α1 agonist ⇒peripheral vasoconstriction, increases SVR and BP
• β1 agonist ⇒positive inotropy, chronotropy, dromotropy
• β2 agonist ⇒bronchodilation
• Blocks destruction of MAST cells (which release Histamine) in anaphylaxis

Question 5

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Pharmacokinetics

Answer 5

Onset of Action < 2 minutes IV, 3-10 minutes IM

Peak Effects < 5 minutes IV, 20 minutes IM

Duration of Effect = 5-10 minutes IV, 20-30 minutes IM

Half-Life = 5 minutes IV

Question 6

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Indications/Field Use:

Answer 6

• Cardiac arrest
• Anaphylaxis/Severe reactive airway disease/asthma
• Symptomatic bradycardia/hypotension

Question 7

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Contraindications:

Answer 7

• HTN and tachydysrhythmias
• use caution with pregnancy and CAD

Question 8

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Side Effects/Adverse Reactions:

Answer 8

• Anxiety
• HA,
• dysrhythmias,
• tremulousness,
• dizziness,
• N+V

*Leads to increased myocardial oxygen demand*

Question 9

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

ADULT DOSE:

Answer 9

• Cardiac arrest : 0.5-1mg IV, IO [1:10,000] q 3-5 min
• Bradycardia/Hypotension : 2-10 μg/min
• Anaphylaxis/Asthma : 0.3-0.5mg IM, SC [1:1000], then 0.1mg [1:10,000]
  slow IV, IO over 3 minutes

Question 10

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

PEDI DOSE:

Answer 10

• Cardiac arrest: 0.01mg/kg IV, IO [1:10,000] q 3-5 min
• Anaphylaxis/Asthma : 0.01mg/kg IM,SC [1:1000], then 0.01mg/kg [1:10,000], max dose 0.3mg, slow IV,IO

Question 11

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Precautions:

Answer 11

Should be protected from light

Question 12

EPINEPHRINE (Adrenalin®, EpiPen®, EpiPen® Jr.)

Drug-Drug Interactions:

Answer 12

• pH dependent,
• deactivated by alkaline solutions;
• effect intensified w/ Pt’s taking antidepressants,
• reacts with CaCl2 and NaHCO3 to form PPT (in IV tubing)