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Pharmacology > Epinephrine Hydrochloride > Flashcards

Epinephrine Hydrochloride Flashcards

0
Q

Drug classification

A

Sympathomimetic agent (catecholamine)

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1
Q

Trade name

A

Adrenalin

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2
Q

Actions (5)

A
  1. Increases cardiac output due to increased inotropy, chronotropy, and AV conduction (Dromotrophy) (beta-1 effect)
  2. increases systolic blood pressure due to increased cardiac output and vasoconstriction (beta-1, Alpha effect)
  3. Increases coronary perfusion during CPR by increasing aortic diastolic pressure (Alpha effect)
  4. Prevents hypotension and loss of intravascular fluid in anaphylactic reactions by counteracting vasodilation and decreases vascular permeability (Alpha effect)
  5. Relaxes smooth muscles of the respiratory tract (beta-2 effect)
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3
Q

Indications (5)

A 
1. Cardiopulmonary arrest
Ventricular fibrillation 
asystole 
pulseless ventricular tachycardia 
pulseless electrical activity (PEA)
  1. Asthma/severe allergic reaction
  2. anaphylaxis with shock
  3. Pediatric bradycardia
  4. Severe respiratory distress with stridor and croup
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4
Q

Contraindications (2)

A
  1. Hypovolemia

2. Hypertension

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5
Q

Adverse effects - cardiovascular (5)

A 
Tachycardia 
Hypertension 
Palpitations 
Chest pain
Ventricular fibrillation
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6
Q

Adverse effects - gastrointestinal (2)

A

Nausea/vomiting

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7
Q

Adverse effects - neurological (5)

A

Anxiety/restlessness
Headache
Tremors/seizures
Dizziness

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8
Q

Administration- cardiac arrest

A

1mg (1:10,000) IVP or IO

May repeat dose for either route every 3-5 minutes.

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9
Q

Administration - asthma/allergic reaction

A

0.3 mg (1:1,000) SQ

May repeat every 20 minutes x 2

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10
Q

Administration - anaphylaxis with shock

A

0.1 mg (1:10,000) slowly (over 1 minute) IVP
May repeat every 3-5 minutes

Or

0.5 mg (1:1,000) IM if unable to obtain venous access

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11
Q

Pediatrics - cardiac arrest

A

0.01mg/kg (1:10,000) IVP or IO

May repeat every 3-5 minutes

Maximum single dose is 1mg

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12
Q

Pediatrics - asthma/allergic reaction

A

0.01mg/kg (1:1,000) SQ

Maximum single dose 0.3mg

May repeat every 20 minutes x 2

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13
Q

Pediatrics - anaphylaxis with shock

A

0.01mg/kg (1:10,000) slowly (over 1 minute) IVP

(Maximum single dose 0.1mg)

May repeat every 3-5 minutes

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14
Q

Administration - Bradydysrhythmia

A

0.01mg/kg (1:10,000) IVP

Maximum single dose is 0.1mg

May repeat 0.02 mg/kg IVP every 3-5 minutes

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15
Q

Pediatrics - stridor with croup

A

less than and equal to 1 year
2.5 mg (1:1,000) diluted with 5mL NS via HHN

Greater than and equal to 1 year
5mg (:1,000) diluted with 5mL NS via HHN

16
Q

Onset

A

Immediate if given IVP or IO

5-10 min SQ

17
Q

Duration

A

3-5 min if given IVP or IO

20 min if SQ

18
Q

Precautions

Flush IV tubing before and after administration of sodium bicarbonate

A

rationale

Inactivated by sodium bicarbonate

19
Q

Precautions

Give slow IVP

A

Rationale

Rapid IV administration may cause cardiac arrest

20
Q

Precautions

Monitor blood pressure, pulse and ECG rhythm frequently after administration

A

Rationale

High incidence of cardiovascular side effects especially in patients over 40 years of age or with hypertension

21
Q

Precautions

Follow cardiac does with 20 mL flush and elevate arm for 10-20 sec

A

Rationale

Ensures dose reaches central circulation

22
Q

Precautions

Provide oxygen

A

Rationale

Myocardial oxygen requirements are increased

23
Q

Precautions

Observe IV site

A

Rationale

tissue ischemia and necrosis my results if IV infiltration occurs

24
Q

Note

A

2 mg may be given down ET, but preferred method of delivery is IVP or IO

croup is usually found in children 3 months to 5 years of age.

Maximum dose 5 mg

rebound stridor or croup may occur. Must transport for further care.

Hold epi if heart rate is greater than 200 bpm

25
Q

806 – cardiopulmonary arrest adult

A

1 mg IV or IO

26
Q

806 - cardiopulmonary arrest pediatrics

A

0.01 mg/kg IV or IO

27
Q

806 - severe anaphylaxis adult

A

0.1 mg slow IVP (of 1:10,000)

28
Q

806 - severe anaphylaxis pediatric

A

0.01 mg/kg slow IVP (of 1:10,000)

Maximum single dose 0.1mg

Pharmacology (32 decks)

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