Name: Class: Description/Mechanism:

epinephrine (Adrenalin) Sympathomimetic Epinephrine stimulates alpha, beta 1 and beta 2 adrenergic receptors in dose-related fashion. Rapid injection produces a rapid increase in blood pressure, ventricular contractility, and heart rate. In addition, epinephrine causes vasoconstriction in the arterioles of the skin and mucosa. It antagonizes the effects of histamine by decreasing its release and decreasing membrane permeability. (SQ) 5-10 minutes (IV, ET) 1-2 minutes 5-10 minutes

Onset:

Duration: Indications: Adverse Reactions:

Bronchoconstriction Anaphylaxis All forms of cardiac arrest Profound symptomatic bradycardia Contraindications Hypersensitivity Hypovolemic shock Coronary insufficiency Hypertension Headache, nausea, restlessness Weakness, dysrhythmias, hypertension Precipitation of angina pectoris MAO inhibitors and bretylium may potentiate the effect of epinephrine Beta adrenergic antagonists may blunt inotropic response. Sympathomimetics and phosphodiesterase inhibitors may exacerbate dysrhythmia response. May be deactivated by alkaline solutions (sodium bicarbonate, Furosemide)

Drug Interactions

Supplied 1mg/ml (1:1,000) 0.1mg/ml (1:10,000) ampule and prefilled syringes Dose/Administration Cardiac Arrest (all rhythms)

Adult
1mg IV or 2 2 times the IV dose via ET, repeat every 3-5 minutes. Initial Dose: IV/IO 0.01mg/kg (1:10,000) ET dose is 0.1 ml/kg (1:1,000) diluted to 3-5 ml Repeat Doses: IV/IO/ET 0.1ml/kg (1:1,000) every 3-5 minutes

Pediatric

Allergic Reactions/Bronchoconstriction

Adult
Moderate allergice reaction/bronchoconstriction 0.3-0.5mg (1:1,000) SQ Anaphylaxis (Severe allergic reaction) 1 mg (1:10,000) slow IV

Pediatric
Infusion Moderate allergice reaction/bronchoconstriction o ml/kg (1:1,000) SQ Anaphylaxis (Severe allergic reaction) 0.05-0.5 mcg/kg/min INFUSION

Adult
2-10 mcg/min titrated to increased HR/BP Suggested concentration: mix 1 mg in 500 ml solution to get 2 mcg/ml concentration

Pediatric
0.1 mcg/kg/min titrated to increase HR/BP Suggested concentration: mix 0.6 mg/kg to create a 100 ml solution. Special Consideration Pregnancy Safety: Category C Do not use prefilled syringes for epinephrine infusions Syncope has occurred following epinephrine administration to asthmatic children. May increase myocardial oxygen demand