Epinephrine (Adult) & Diphenhydramine

Question 1

Epinephrine

Brand Name

Answer 1

Adrenalin

Question 2

Epinephrine

Class

Answer 2

Sympathomimetic

Question 3

Epinephrine

Supply

Answer 3

-prefilled syringe
-vial
-ampule
- auto-injectors (Adult EpiPen and EpiPen Jr.)

Question 4

Epinephrine

Mechanism of Action

Answer 4

-Alpha-adrenergic response: vasoconstriction
-Beta 1 adrenergic responses: increase heart rate, increase myocardial contractility
-Beta 2 adrenergic response: relaxes bronchial smooth muscle resulting in bronchodilation
-blocks histamine receptors

Question 5

Epinephrine

Indications

Answer 5

-cardiac arrest: asystole, pulseless electrical activity, ventricular fibrillation, pulseless ventricular tachycardia
-hemodynamically significant hypotension from a cause other than hypovolemia
-asthma
-bronchospasm associated with chronic bronchitis and emphysema
-allergic reaction
-anaphylaxis
-hemodynamically significant bradycardia

Question 6

Epinephrine

Contraindication

Answer 6

none in the emergency settting

Question 7

Epinephrine

Adverse Reactions

Answer 7

-extravasation of IV/IO may cause tissue necrosis
-tachycardia
-increased myocardial oxygen demand
-hypertension
-dysrhythmias
-dyspnea
-palpitations
-chest pain
-nervousness
-anxiety
-dizziness
-headache
-tremors
-nausea, vomiting

Question 8

Epinephrine

Routes

Answer 8

-IV
-IO
-IM
-ET
-infusion

Question 9

Epinephrine

Onset

Answer 9

immediate

Question 10

Epinephrine

Adult Dosages
Cardiac Arrest IV/IO

Answer 10

1.0 mg (1:10,000)
may repeat every 3-5 minutes during resuscitation

Question 11

Epinephrine

Adult Dose
Cardiac Arrest ET

Answer 11

2.0-2.5 mg (1:1,000) diluted in 10 mL NS
may repeat every 3-5 minutes during resuscitation

Question 12

Epinephrine

Adult Dose
Hemodynamically significant bradycardia

Answer 12

2.0-10 mcg/minute infusion

Question 13

Epinephrine

Adult Dose
Hemodynamically significant hypotension

Answer 13

2.0-10 mcg/minute infusion

Question 14

Epinephrine

Adult Dose
Bronchospasm associated with chronic bronchitis and emyphysema/allergic reaction/anaphylaxis

Answer 14

• 0.3-0.5 mg (1:1,000) IM
• Adult EpiPen auto-injector 0.3 mg IM

Question 15

Epinephrine

Special Considerations

Answer 15

-drug can increase adverse reactions and side effects when administered with another sympathomimetic drug
-infusion pump should be used when possible

Question 16

Diphenhydramine

Brand Name

Answer 16

Benadryl

Question 17

Diphenhydramine

Classes

Answer 17

-antihistamine
-anticholinergic

Question 18

Diphenhydramine

Supply

Answer 18

-vial
-prefilled syringe

Question 19

Diphenhydramine

Mechanism of Action

Answer 19

-blocks H1 histamine receptors
-reverse phenothiazine reaction with extrapyramidal symptoms

Question 20

Diphenhydramine

Indications

Answer 20

-allergic reaction
-anaphylaxis
-phenothiazine reaction with extrapyramidal symptoms

Question 21

Diphenhydramine

Contraindication

Answer 21

known hypersensitivity to drug

Question 22

Diphenhydramine

Adverse Reactions

Answer 22

-hypotension
-dysrhythmias
-sedation
-euphoria
-dizziness
-headache
-blurred vision
-palpitations

Question 23

Diphenhydramine

Routes

Answer 23

-IV
-IO
-IM

Question 24

Diphenhydramine

Onset

Answer 24

15-30 minutes

Question 25

Diphenhydramine

Adult Dosages

Answer 25

Allergic reaction/anaphylaxis: 25-50 mg
Phenothiazine reaction with extrapyramidal symptoms: 10-50 mg

Question 26

Diphenhydramine

Pediatric dosages

Answer 26

1.0-1.25 mg/kg

Question 27

Diphenhydramine

Special Considerations

Answer 27

Consider dosage of drug accords to severity of allergic reaction or anaphylaxis