PHARMACOLOGY AND ACTIONS:
- Catecholamine with alpha and beta effects.
- 2. In
- general, the following cardiovascular responses can be expected:
A. Increased heart rate.
B. Increased myocardial contractile force.
C. Increased systemic vascular resistance.
- Increased arterial blood pressure.
- E. Increased myocardial O2
F. Increased automaticity.
- Ventricular fibrillation/ventricular tachycardia without a pulse.
- 2. Pulseless electrical
1. Systemic allergic reactions.
2. Asthma in patients under 50.
- 3. Sinus Bradycardia
- unresponsive to Dopamine, Bradycardia secondary to calcium channel blocker or
- beta-blocker overdose.
- 1. Should not
- be added directly to bicarbonate infusion, since catecholamines may be
- partially inactivated by alkaline solution.
- 2. When used
- for allergic reactions, increased cardiac work can precipitate angina and/or MI
- in susceptible individuals. Epinephrine
- may also induce major arrhythmias.
- 3. Due to
- peripheral vasoconstriction, epinephrine should be used with caution in
- patients with peripheral vascular insufficiency.
- 4. Wheezing
- in an elderly person is pulmonary edema or pulmonary embolus until proven
- 1. 1:10,000
- administration. 1 mg (10ml 1:10,000
- solution) every 3-5 minutes during arrest.
- 1:1000 administration. May be used in cardiac arrest. The dose is 1mg (1cc) for the initial dose
- every 3-5 minutes. It must be
- administered through a rapidly running IV (Marco drip). Epinephrine given through the
- E.T. tube must be either
- 1:10,000 or 1:1000 diluted with saline.
- B. Allergic reaction (anaphylactic shock,
- laryngeal edema, severe asthma): 0.3 mg -0.5mg
- (0.3-0.5 ml of 1:1000 solution), SQ or IM, or if in profound shock,
- of 1:10,000 solution IV. May be repeated
- x 2.
- Bradycardia: Epinephrine 2 to
- 10ug/min (1mg/250cc equals 4ug/ml)
- A. Cardiac arrest: 0.01 mg/kg (1:10,000 =
- 0.1ml/kg) IV/IO
- also be given via endotracheal tube:
- 0.1mg/kg (1:1,000=0.1ml/kg).
Repeat every 3-5 minutes.
- Allergic reaction
- (anaphylactic shock, laryngeal edema, severe asthma) 0.01 mg/kg (0.01 ml/kg of
- 1:1,000 solution), SQ, IM, or if in profound shock, 0.01mg/kg 1:10,000 solution
- C. Severe Bradycardia with shock (patients close
- to the state of PEA, Asystole). IV/IO 0.01mg/kg (0.1ml/kg of 1:10,000) may
- repeat every 3-5 min if necessary.
SIDE EFFECTS AND SPECIAL NOTES:
1. Anxiety, tremor, headache.
2. Tachycardia, palpitations, PVC's
3. Angina, hypertension.