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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
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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
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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.......!!!!
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