Epinephrine(Adrenalin) Class Sympathomimetic Epinephrine(Adrenalin) MOA Direct acting alpha/beta agonist Alpha: Vasoconstriction Beta-1: Positive Inotropic, Chronotropic and Dromotropic effects Beta-2: Bronchial smooth muscle relaxation and dilation of skeletal vasculature Epinephrine(Adrenalin) Indication Cardiac Arrest(V-fib, Pulseless V-Tach, Asystole, PEA) Symptomatic bradycardia as an alternative infusion to Dopamine Severy hypotension secondary to bradycardia when Atropine and transcutaneous pacing are unsuccessful Allergic reaction Anaphylaxis Asthma Epinephrine(Adrenalin) Contraindication Hypothermia Pulmonary edema Myocardial ischemia Hypovolemic shock Relative Contraindication: Underlying cardiovascular disease/angina Hypotension Pregnancy Pts over 40yrs Hyperthyroidism Epinephrine(Adrenalin) Adverse Hypertension Tachycardia Arrhythmias Pulmonary edema Anxiety Restlessness Psychomotor agitation Nausea Headache Angina Epinephrine(Adrenalin) Dosage Adult: Mild allergic reaction and asthma: 0.3-0.5mg 1:1,000 SQ Anaphylaxis: 0.05-0.1mg 1:10,000 IV/IO over 5mins Cardiac arrest: IV/IO: 1mg 1:10,000 every 3-5mins during resuscitation. Follow each dose with 20mL flush and elevate arm for 10-20sec after dose. Higher doses(up to 0.2mg/kg) may be administered for specific conditions(beta-blocker/Calcium channel-blocker OD) ET: 2-2.5mg diluted in 10mL NS Continuous Infusion: Add 1mg of 1:1,000) to 500mL of NS or D5W. Initial infusion rate of 1mcg/min titrated to effects(typical dose 2-10mcg/min)Profound hypotension: 2-10mcg/min titrated Peds: Mild allergic reaction and asthma: 0.01mg/kg of 1:1,000 SQ Max 0.3mg Cardiac arrest: IV/IO: 0.01mg/kg of 1:10,000 every 3-5mins during arrest ET: 0.1mg/kg of 1:1,000 Continuous IV infusion: Begin with rapid infusion, then titrate to response. Typical initial infusion- 1mcg/min. Higher doses may be effective Hollyshit.......!!!!