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Functional Class
Sympathomimetic
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How it is supplied
- 1:1000 - 1mg/ml
- 1:10,000 - 0.1mg/ml
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Mechanism of Action
Naturally occuring catecholamine. Acts directly on alpha and beta (primarily) adrenergic receptors. Causes positive inotropic, chronotrpic and dromotropic effects as well as increased vascular resistance in BP.
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Indications
- Cardiac Arrest (Asystole, VF, Pulseless VT, PEA)
- Symptomatic bradycardia
- Anaphylaxis
- Severe reactive airway disease
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Contraindications
Hypersensitivity to sympathomimetic amines
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Precautions
- Protect from light
- Can be deactivated by sodium bicarbonate. Flush IV between using epi and bicarb
- Effects intensified by anti-depressants
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Side Effects
- Increases myocardial oxygen demand
- Palpitations
- Anxiety
- Headache
- CVA
- Syncope
- HTN
- Tachydysrhythmias
- Tissue necrosis with repeated injections or extravasation of IV
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Drug Interactions
- May increase hypotension caused by phenotiazines, alpha and beta blockers
- Can be deactivated in alkaline solutions or sodium bicarbonate
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Dosage and Route
- Cardiac Arrest
- ADULT
- 1.0 mg 1:10,000 IVP q 3-5 mins
- 2.0-2.5 mg 1:1,000 ET diluted to 10 mL q 3-5 mins
- PEDI
- 0.01 mg/kg 1:10,000 IV/IO
- 0.1 mg/kg 1:1,000 ET diluted to 10 mL q 3-5 mins
- Severe Anaphylaxis/AsthmaADULT
- 0.3-0.5 mg SQ 1:1,000 q 5-15 mins then if ineffective 0.1-0.5 mg IVP 1:10,000 q 5-15 mins
- PEDI
- 0.01 mg/kg 1:1,000 SQ then if ineffective 0.01 mg/kg IVP 1:10,000 q 5-15 mins
- Symptomatic Bradycardia Infusion1 mg of 1:1000 in 250 mL NS
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