Epinephrine

Front 1

Epinephrine (Adrenalin)

Class

Back 1

Sympathomimetic, Catecholamine, Vasopressor

Front 2

Epinephrine (Adrenalin)

MOA

Back 2

1. Increases cardiac output due to increased inotropy, chronotropy, and AV conduction (beta1 effect)
2. Increases systolic blood pressure (alpha and beta1 effect)
3. Relaxes the smooth muscles in the respiratory tract (beta2 effect)
4. Increases coronary perfusion during CPR by increasing aortic diastolic pressure
5. Dilates the bronchioles (beta2 effect)

Front 3

Epinephrine (Adrenalin)

Indications

Back 3

1. Cardiac Arrest
2. Asthma
3. Allergic reaction and Anaphylactic shock

Front 4

Epinephrine (Adrenalin)

Contraindications

Back 4

1. Hypovolemia
2. HTN

Front 5

Epinephrine (Adrenalin)

Side Effects

Back 5

Cardiovascular: tachycardia, hypertension, palpitations, chest pain, ventricular fibrillation
Neurological: tremors/seizures
Respiratory: paradoxical bronchospasms (with excessive use in inhalers)

Front 6

Epinephrine (Adrenalin)

Precautions

Back 6

1. Give slow IVP in conscious patients as it may cause permanent hearing loss
2. Monitor blood pressure and ECG frequently after administration due to the high incidence of cardiovascular side effects in patients above the age of 40

Front 7

Epinephrine (Adrenalin)

Interactions

Back 7

Flush tubing before and after administration of Sodium Bicarbonate, as Epinephrine will be inactivated by the change in pH

Front 8

Epinephrine (Adrenalin)

Adult
Routes / Dosages

Back 8

IVP, IO, SQ, ET (can consider IM administration)

Cardiac Arrest: 1 mg (1:10,000) IVP/IO or 2 mg (1:1,000) ET
May repeat every 3-5 minutes
Asthma/Allergic Reaction:
0.3 mg- 0.5 mg (1:1,000) SQ (if patient is perfusing)
May repeat every 20 minutes x 2
Anaphylaxis with Shock:
0.1 mg (1:10,000) slow IVP/IO (over 1 minute)
May repeat every 3-5 minutes

Front 9

Epinephrine (Adrenalin)

Pediatrics
Routes / Dosages

Back 9

Cardiac Arrest: 0.01 mg/kg (1:10,000) IVP/IO or 0.1 mg/kg (1:1,000) ET
May repeat 0.01 mg/kg IVP/IO/ET every 3-5 minutes
Subsequent doses may switch to a 1:1,000 concentration
Asthma/Allergic Reaction:
0.01 mg/kg (1:1,000) SQ to a maximum single dose
of 0.3 mg (if patient is perfusing)
May repeat every 20 minutes x 2
Anaphylaxis with Shock:
0.01 mg/kg (1:10,000) slow IVP/IO (over 1 minute) to a maximum single dose of 0.1 mg
May repeat every 3-5 minutes
Bradydysrhythmia (<80 HR for neonate/infant or <60 HR for child):
Neonate/Infant 0.01 mg/kg (1:10,000) IVP/IO or 0.1 mg/kg (1:1,000) ET
May repeat 0.1 mg/kg IVP/IO/ET every 3-5 minutes
Child 0.01 mg/kg (1:10,000) IVP/IO or 0.1 mg/kg (1:1,000) ET
If no response, consider Atropine