DRUG STUDY: EPINEPHRINE

Drug Name Drug Classification Mechanism of Action and Drug Action Drug Effects Interactions
Indications (Serious/Common)
Generic Name: Pharmacologic: Mechanism of Action: Pharmacokinetics Side effects (common by Drug – Drug
system):
Epinephrine Adrenergics Epinephrine acts on alpha and A: Well absorbed following Concurrent use with other
beta-adregenic receptors. subcut administration; some CNS: nervousness, adrenergic agents will have
Trade Name:
Therapeutic: Epinephrine acts on alpha and absorption may occur restlessness, tremor, additive adrenergic side
Adrenalin beta receptors and is the following repeated headache, insomnia. effects.
Sus-Phrine antiasthmatics, strongest alpha receptor inhalation of large doses.
EpiPen bronchodilators, activator. Through its action on CV: angina, Use with MAO inhibitors
vasopressors alpha-adregenic receptors, D: Does not cross the arrhythmias, may lead to hypertensive
epinephrine minimizes the blood-brain barrier; crosses hypertension, crisis.
Dosage: vasodilation and increased the the placenta and enters tachycardia.
Recommended: vascular permeability that breast milk. Beta blockers may negate
occurs during anaphylaxis, Derm: skin and soft therapeutic effect.
Subcut, IM (Adults and which can cause the loss of M and E: Action is rapidly tissue infections
Children _30 kg): Severe intravascular fluid volume as terminated by metabolism (including necrotizing Tricyclic antidepressants
anaphylaxis—0.3–0.5 mg well as hypotension. and uptake by nerve fasciitis and enhance pressor response to
(single dose not to exceed Epinephrine relaxes the smooth endings. myonecrosis). epinephrine.
0.5 mg); may repeat every muscles of the bronchi and iris
10–15 min as needed. and is a histamine antagonist, Half-life: 2 minutes GI: nausea, vomiting. Drug – Food/Herbs
rendering it useful in treating
IV (Adults): Severe the manifestation of allergic Endo: hyperglycemia. Use with caffeine-containing
anaphylaxis—0.1–0.25 reaction and associated herbs (cola nut, guarana,
mg every 5–15 min; may conditions. This drug also mate, tea, coffee)
be followed by 1–4 produces an increase increase stimulant effect.

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 1
 mcg/min continuous glycogenolysis in the liver. Pharmacodynamics Adverse Reactions Drug – Laboratory
infusion; Through its action on beta- Route: Inhaln (Serious, life
cardiopulmonary adregenic receptor, epinephrine Onset: 1 min threatening) Treatment of Overdose/
resuscitation (ACLS leads to bronchial smooth Peak: unknown Life-threatening Antidote (if any):
guidelines)—1 mg every muscle relaxation that helps to Duration: 1 – 3 hrs
3–5 min; bradycardia relieve bronchospasm, Resp: PARADOXICAL
(ACLS guidelines)—2–10 wheezing, and dyspnea that may Route: Subcut BRONCHOSPASM
mcg/min). occur during anaphylaxis. Onset: 5 – 10 min (EXCESSIVE
Peak: 20 min USE OF INHALERS).
Intracardiac (Adults): Duration: <1 – 4 hrs
0.3–0.5 mg. Indication(s): WARNING: Because of
Route: IM vasoconstrictive effect,
Inhaln (Adults): • Subcut, IM, IV: Onset: 6 – 12 min care must be taken to
Inhalation solution—1 Management of severe Peak: unknown avoid extravasation of
inhalation of 1% solution; allergic reactions. Duration: <1 – 4 hrs any infused drugs. The
may be repeated after 1–2 vasoconstriction in the
min; additional doses may • IV, Intracardiac, Route: IV area of extravasation can
be given every 3 hr; Intratracheal, Onset: rapid lead to necrosis and cell
racepinephrine Via hand Intraosseous (part of Peak: 20 mins death in that area.
nebulizer, 2–3 inhalations advanced cardiac life Duration: 20 – 30 mins
of 2.25% solution; may support [ACLS] and Contraindication
repeat in 5 min with 2–3 pediatric advanced life
more inhalations, up to 4– support [PALS] Hypersensitivity to
6 times daily. guidelines): adrenergic amines; Some
Management of cardiac products may contain
Endotracheal (Adults): arrest (unlabeled). bisulfites and should be
Cardiopulmonary avoided in patients with

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 2
 resuscitation (ACLS • Subcut, IM: known hypersensitivity
guidelines)—2–2.5 mg. Management of or intolerance.
reversible airway disease
Topical (Adults and due to asthma or COPD
Children _6 yr): Nasal (unlabeled).
decongestant— Apply 1%
solution as drops, spray, • Inhaln: Management of
or with a swab. upper airway obstruction
and croup (racemic
Intraspinal (Adults and epinephrine).
Children): 0.2–0.4 mL of
1:1000 solution. • Local/Spinal: Adjunct
in the
With Local Anesthetics localization/prolongation
(Adults and Children): of anesthesia.
Use 1:200,000 solution
with local anesthetic.

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 3
Nursing Process: Epinephrine
Assessment
▪ Assess for
contraindications or
cautions, such as
history of allergy,
pheochromocytoma,
fatal arrhythmias, etc.,
to avoid adverse effect.
▪ Establish baseline
physical assessment to
monitor for any
potential adverse
effect.
▪ Assess vital signs,
especially pulse and
blood pressure to
monitor for possible
excess stimulation of
the cardiac system.
▪ Note respiratory rate
and auscultate lungs for
adventitious sounds to
Janeirah Q. Manalundong
Faculty, College of Health Sciences
Nursing Diagnoses Planning Nursing Interventions with Appropriate Patient Evaluation/ Expected
(Priority Problems) Rationale (Italic) Teaching/Education Outcomes of Care
▪ Ineffective Tissue The patient will: ▪ Monitor vital signs and lung General ▪ Monitor patient
Perfusion, related to sounds, including croup and response to therapy
cardiovascular effects ▪ Demonstrate wheezing (to determine ▪ Instruct patient to report (improvement in
of drug. understanding of the effectiveness of drug therapy.) changes in respiratory blood pressure,
risks and benefits of drug status to the health care ocular pressure,
▪ Disturbed Sleep therapy. ▪ Monitor blood glucose. (Use provider. bronchial airflow).
Pattern, related to with caution in patients with
CNS effects of drug. ▪ Maintain adequate tissue diabetes mellitus due to ▪ Advise patient to monitor ▪ Monitor for adverse
perfusion. epinephrine’s effect of blood glucose frequently effects (e.g. CV
▪ Imbalanced Nutrition: increasing hyperglycemia.) during treatment. changes, decreased
Less than Body ▪ Maintain adequate sleep. urine output,
Requirements, related ▪ Obtain history of closed angle ▪ Instruct patient to headache, GI upset).
to anorexia secondary ▪ Demonstrate glaucoma. (Drug dilates the immediately report vision
to drug. maintenance of weight pupil, which may lead to changes to the health care ▪ Evaluate patient
within normal range. worsening of condition.) provider. understanding on
▪ Deficient Knowledge, drug therapy by
related to drug action ▪ Use with caution in patients ▪ Instruct the patient to notify asking patient to
and side effects with hyperthyroidism (due to the health care provider if name the drug, its
exacerbation of thyroid crisis.) they experience; increased indication, and
heart rate, fever, adverse effects to
▪ Monitor cardiovascular status. nervousness, tremors. watch for.
(Cardiac arrhythmias may
occur and may lead to
ventricular fibrillation.
NSG 105: PHARMACOLOGY DRUG STUDY 4
 evaluate effects on Hypertensive crisis may ▪ Advise patient that cardiac ▪ Monitor patient
bronchi and occur.) monitoring will occur while compliance to drug
respirations. receiving this medication. therapy.
▪ Monitor neurological status.
▪ Monitor urine output to (Drug may cause cerebral ▪ Instruct patient to
evaluate perfusion of hemorrhage.) immediately report the first
the kidneys and signs of severe headache.
therapeutic effects.

▪ Monitor laboratory test

results, e.g. liver and
renal function tests) to
determine need for
possible dose
adjustment, and serum
electrolyte levels to
evaluate fluid loss and
appropriateness of
therapy.

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 5