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12 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the best-known trade name for epinephrine?
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Adrenalin
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Epinephrine is known as "adrenaline" in most of the world but the term is not used in the US due to its similarity to the trademarked "Adrenalin".
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What is the functional class of epinephrine?
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Sympathomimetic
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In the human body, the most abundant catecholamines (which all have sympathomimetic effects) are epinephrine, norepinephrine and dopamine.
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What is the mechanism of action of epinephrine?
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A naturally-occurring catecholamine that acts directly on the alpha- and beta- (more profound) adrenergic receptors. This causes positive inotropic, dromotropic, and chronotropic effects as well as increased systemic vascular resistance and BP.
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- Inotropic - increased contractility
- Dromotropic - increased conduction velocity - Chronotropic - increased rate |
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What are the listed indications for epinephrine?
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- Cardiac arrest: asystole, VF, pulseless VT, PEA
- Symptomatic bradycardia - Anaphylaxis - Severe reactive airway disease |
Epinephrine is also used as a local vasoconstrictor in local anesthetics and in ointments to stop bleeding in contact sports such as boxing.
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What are the listed contraindications for epinephrine?
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Hypersensitivity to sympathomimetic amines
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Some sources state that epinephrine is contraindicated for patients on nonselective β-blockers because severe hypertension may result as only the α-adrenergic effects will be produced.
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What are the listed precautions for epinephrine?
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- Protect from light
- Can be deactivated by sodium bicarbonate, therefore flush IV line between administration of epinephrine and sodium bicarbonate. - Effects can be intensified by antidepressants |
Furosemide (Lasix) can also block the effects of epinephrine.
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What are the listed side effects for epinephrine?
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- Increases myocardial oxygen demand
- Can cause palpitations, anxiety, headache, CVA, syncope, HTN, tachydysrhythmias - Tissue necrosis with repeated injections or extravasation of IV |
Some sources add acute pulmonary edema as a side effect of epinephrine.
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What are the listed interactions for epinephrine?
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- May increase hypotension caused by phenothiazines, alpha and beta blockers
- Can be deactivated in alkaline solutions or sodium bicarbonate |
Tricyclic antidepressants can potentiate epinephrine by inhibition of norepinephrine reuptake.
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What is the dosage and route of epinephrine for cardiac arrest?
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Adult:
- 1.0mg of 1:10,000 IVP q 3 - 5 minutes or 2.0 - 2.5mg of 1:1,000 ET q 3 - 5 minutes (diluted to 10mL) Pedi: - 0.01mg/kg of 1:10,000 IV/IO or 0.1mg/kg of 1:1,000 ET q 3 - 5 minutes (diluted to 3 - 5mL) |
Note that the differing routes use differing concentrations. High-dose epinephrine is ET (as it is being diluted), low-dose is IV/IO.
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What is the dosage and route of epinephrine for severe anaphylaxis/asthma?
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Adult:
- 0.3 - 0.5mg of 1:1,000 SQ q 5 - 15 minutes, - If ineffective give 0.1 - 0.5mg of 1:10,000 IVP q 5 - 15 minutes Pedi: - 0.01mg/kg of 1:1,000 SQ - If ineffective give 0.01mg/kg of 1:10,000 IVP q 5 - 15 minutes |
First dose is high-dose SQ, second dose is low-dose IVP.
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What is the dosage and route of epinephrine for symptomatic bradycardia (as an infusion)?
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Preparation: 1 mg of 1:1,000 in 250mL NS
Adult: - 2 - 10mcg/min Pedi: - 0.1 - 1mcg/kg/min |
This is high-dose epinephrine as it is being diluted for infusion.
NH EMS protocols do not include epinephrine infusion for pediatric patients. |
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What are the pharmacokinetics of epinephrine?
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None listed.
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One source states:
Onset: 5 - 10 min SQ, 1 - 2 min IV Duration: 5 - 10 min |
