Racemic epinephrine Flashcards
Racemic epinephrine Trade Name?
Racemic epinephrine (Vaponefrin, Micronefrin)
Racemic epinephrine Classification?
Sympathomimetic
Racemic epinephrine Mechanism?
Beta 2 agonist causing bronchial smooth muscle relaxation to cause bronchodialtion. Inhibits histamine release.
Racemic epinephrine Indications?
CT Protocols: Bronchiolitis, Croup
Capital: Relieves subglottic edema associated with Croup and Laryngeal edema
REMSA: Laryngotracheobronchitis (croup), asthma, bronchospasms, laryngeal edema
Racemic epinephrine Contraindications?
Capital: Hypersensitivity Hypertension, Epiglottitis, Significant cardiovascular disease
Racemic epinephrine Side Effects/Precautions?
Capital: Tachycardia, Hypertension, Increased myocardial oxygen demand, Dysrhythmia, Headache, Nausea/vomiting, Syncope
Beta blockers may blunt effects
Racemic epinephrine Adult Dose?
Not typically used for adults.
Racemic epinephrine Pediatric Dose?
Capital: 0.25 – 0.75ml of 2.25% solution in total of 3ml via small volume nebulizer
5 mg epinephrine 1:1,000 may be nebulized if racemic epinephrine is not available
CT Protocols:
BRONCHIOLITIS
For patients who do not respond to suctioning or for impending respiratory failure, consider: Nebulized racemic epinephrine 0.5 ml of 2.25% (11.25mg) with 3 mL 0.9% NaCl OR Nebulized epinephrine, 5 mg of 1mg/ml (1:1,000).
CROUP
Dexamethasone 0.6 mg/kg by mouth or IM/IV/IO (by mouth preferred) maximum 10mg Croup with stridor at rest, OR
Nebulized racemic epinephrine 0.5 ml of 2.25% (11.25mg) w/ 3 mL 0.9% NaCl OR
Nebulized epinephrine, 5 mg of 1mg/ml (1:1,000). [* HIGH-RISK AGP*]
Racemic epinephrine Onset of Action?
5 minutes
Racemic epinephrine Duration of Action?
1-3 hours
Racemic epinephrine Max Dose Adult/Pediatric?
12 inhalations in a 24 hour period.
Racemic epinephrine Routes of Administration?
Nebulizer
Racemic epinephrine How Supplied?
2.25% solution
