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 (force of contraction)
• chronotropy (heart rate)
• dromotropy (conduction speed)
• β2 agonist ⇒ bronchodilation
• Blocks destruction of MAST cells in anaphylaxis

*MAST cells contain Histamine & Heparin which is released when destroyed 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 & Contraindications

Answer 6

Indications/Field Use:
• Cardiac arrest
• Anaphylaxis/Severe reactive airway disease/asthma
• Symptomatic bradycardia/hypotension

Contraindications:
• HTN and tachydysrhythmias

• use caution with pregnancy and CAD (Cornary Artery Disease)

Question 7

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

Side Effects/Adverse Reactions:

Answer 7

Anxiety, HA, tremulousness, dizziness, N+V

dysrhythmias

*Leads to increased myocardial oxygen demand*

Question 8

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

Adult & Pedi Dose:

Answer 8

• *Cardiac arrest (ADULT):** 0.5-1mg IV, IO [1:10,000] q 3-5 min
• *Cardiac arrest (PEDI):** 0.01mg/kg IV, IO [1:10,000] q 3-5 min

Bradycardia/Hypotension (ADULT): 2-10 μg/min

• *Anaphylaxis/Asthma (ADULT):** 0.3-0.5mg IM, SC [1:1000], then 0.1mg [1:10,000] slow IV, IO over 3 minutes
• *Anaphylaxis/Asthma (PEDI):** 0.01mg/kg IM,SC [1:1000], then 0.01mg/kg [1:10,000], max dose 0.3mg, slow IV,IO

Question 9

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

Precautions:

Answer 9

Should be protected from light

Question 10

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

Drug-Drug Interactions:

Answer 10

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