Group 3 - Epinephrine HCl

Question 1

Epinephrine HCl

Drug Class?

Answer 1

Epinephrine HCl

Drug Class:

• Sympathomimetic

Question 2

Epinephrine HCl

Mechanism of Action (MOA)?

Answer 2

Epinephrine HCl MOA:

• α agonist - vasoconstriction (increased systemic vascular resistance)
• ß₁ agonist - positive inotropic effect (increased cardiac contractility), positive chronotropic effect (increased heart rate), positive dromotropic (increased electrical conduction velocity)
• ß₂ agonist - bronchial smooth muscle relaxation (bronchodilation)
• Increased myocardial workload and oxygen requirements
• Blocks histamine release

Question 3

Epinephrine HCl

Indications?

Answer 3

Epinephrine HCl Indications:

• Cardiac arrest - VF/Pulseless VT, asystole, pulseless electrical activity (PEA)
• Bronchospasm (bronchiolitis, asthma)
• Anaphylaxis
• Bradycardia
• Hypotension unresponsive to other therapy
• Croup

Question 4

Epinephrine HCl

Contraindications?

Answer 4

Epinephrine HCl Contraindications:

• None known for cardiac arrest
• Hypothermia (relative)

Question 5

Epinephrine HCl

Adverse Reactions?

Answer 5

Epinephrine HCl Adverse Reactions:

• CV: hypertension, ventricular dysrhythmias, tachycardia, angina
• CNS: anxiety, agitation
• GI: nausea and vomiting

Question 6

Epinephrine HCl

Adult Dose?

Answer 6

Epinephrine HCl Adult Dose:

• Pulseless Arrest:
• IV/IO: 1 mg of 1 : 10,000 solution every 3 - 5 minutes no max dose followed by 10cc flush
• ET: 2 - 2.5 mg of 1 : 10,000 via ET tube
• Infusion for Hypotension or Symptomatic Bradycardia:
• 1 mg added to 500 ml of NS administered at 1 mcg/min titrated to desired hemodynamic response (range 2 - 10 mcg/min)
• Anaphylaxis and asthma:
• 0.3 - 0.5 mg of 1 : 1,000 IM, SC, SL may repeat every 15 to 20 minutes
• In extreme cases, may give 0.1 mg of 1 : 10,000 solution every 5 minutes IV/IO or continuous IV/IO infusion of 1 - 4 mcg/min

Question 7

Epinephrine HCl

Pediatric Dose?

Answer 7

Epinephrine HCl Pediatric Dose:

• Pulseless Arrest:
• IV/IO: 0.01 mg/kg of 1 : 10,000 solution every 3 -5 minutes, max single dose of 1 mg
• ET: 0.1 mg/kg of 1 : 1,000 diluted with NS to a volume of 3 - 5 ml, max single dose of 10 mg
• Anaphylaxis and asthma:
• 0.01 mg/kg of 1 : 1,000 IM/SC, max single dose of 0.5 mg
• IV Infusion:
• 0.1 - 1 mcg/kg/min
• Croup:
• 3 mg of 1 : 1,000 mixed in 3 ml NS via SVN

Question 8

Epinephrine HCl

Onset of Action?

Answer 8

Epinephrine HCl

Onset of Action:

• Seconds

Question 9

Epinephrine HCl

Peak Effects?

Answer 9

Epinephrine HCl

Peak Effects:

• Minutes

Question 10

Epinephrine HCl

Duration of Action?

Answer 10

Epinephrine HCl

Duration of Action:

• Several Minutes

Question 11

Epinephrine HCl

AZ Drug Box Minimum Supply?

Answer 11

Epinephrine HCl

AZ Drug Box Minimum Supply:

• 1 : 10,000 prefilled syringes - 5 mg
• 1 : 1,000 - 2 mg
• Optional: 1 : 1,000 multidose vial - 30 mg