Epinephrine Hydrochloride Flashcards
Epinephrine Hydrochloride- Name
Adrenalin
Epinephrine- Class
Sympathomimetic
Catecholamine
Vasopressor
Epinephrine- MoA
Increases cardiac output and BP by increasing inotropy, chronotropy, and dromotropy (beta1 effect)
Vasoconstriction; increases systolic blood pressure (alpha)
Relaxes smooth muscles in the respiratory tract, dilating the bronchioles (beta2 effect)
Increases coronary perfusion during CPR by increasing aortic diastolic pressure (from vasoconstriction)
Epinephrine- Indications
Cardiac Arrest
Asthma Allergic reaction and Anaphylactic shock
Symptomatic Bradycardia (PEDS)
Beta Blocker OD (PEDS)
Epinephrine- Contra
Hypovolemia
Hypertension
Epinephrine- S/E
Cardiovascular: tachycardia, hypertension, palpitations, chest pain, ventricular fibrillation
Neurological: tremors/seizures
Respiratory: paradoxical bronchospasms (with excessive use in inhalers)
Epinephrine- Routes
IV, IO, SQ, IM, ET (neonates only), IVPB
Epinephrine- A. Dose
Cardiac Arrest:
1 mg (1:10,000) IV/IO
May repeat every 3-5 minutes
Asthma/Allergic Reaction:
0.3 mg- 0.5 mg (1:1,000) SQ/IM
May repeat every 20 minutes x 2
Anaphylaxis: mg-0.5mg (1:10,000) slow IV/IO (over 1-5 minutes) May repeat every 3-5 minutes
Vasopressor 1-4 mcg/min IVPB
Epinephrine- P. Dose
Cardiac Arrest:
0.01 mg/kg (1:10,000) IV/IO
May repeat 0.01 mg/kg IV/IO every 3-5 minutes
Asthma/Allergic Reaction:
0.01 mg/kg (1:1,000) SQ/IM to a maximum single dose of 0.3 mg
May repeat every 20 minutes x 2
Anaphylaxis with Shock:
0.01 mg/kg (1:10,000) slow IV/IO (over 1 minute) to a maximum single dose of 0.1 mg
May repeat every 3-5 minutes
Bradydysrhythmia (<60 HR for neonate/infant or <60 HR for child w/ poor perfusion):
Neonate/Infant 0.01 mg/kg (1:10,000) IV/IO/ET (dilute ET dose with 1-2ml of NS) may repeat every 3-5 mins
Child 0.01 mg/kg (1:10,000) IV/IO may repeat every 3-5 mins Vasopressor 1-4 mcg/min IVPB
Epinephrine- EXTRAS
Precautions: Give slow IVP in conscious patients as it may cause permanent hearing loss
Monitor blood pressure and ECG frequently after administration due to the high incidence of cardiovascular side effects in patients above the age of 40 Interactions:
Flush tubing before and after administration of Sodium Bicarbonate, as Epinephrine will be inactivated by the change in pH
Onset in 1-2 minutes if administered IV, IO and may last 3-5 minutes.
SQ administration has an onset of 5-10 minutes and may last 20 minutes
Patient must be perfusing to effectively administer SQ injections
Most bradycardias in infants and children are due to hypoxia – consider aggressive ventilatory support prior to medication administration
