MED-Epinephrine

Sympathomimetic

• 1:1000 - 1mg/ml
• 1:10,000 - 0.1mg/ml

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.

• Cardiac Arrest (Asystole, VF, Pulseless VT, PEA)
• Symptomatic bradycardia
• Anaphylaxis
• Severe reactive airway disease

Hypersensitivity to sympathomimetic amines

• Protect from light
• Can be deactivated by sodium bicarbonate. Flush IV between using epi and bicarb
• Effects intensified by anti-depressants

• Increases myocardial oxygen demand
• Palpitations
• Anxiety
• Headache
• CVA
• Syncope
• HTN
• Tachydysrhythmias
• Tissue necrosis with repeated injections or extravasation of IV

• May increase hypotension caused by phenotiazines, alpha and beta blockers
• Can be deactivated in alkaline solutions or sodium bicarbonate

• 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/Asthma
• ADULT
• 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 Infusion
• 1 mg of 1:1000 in 250 mL NS

• ADULT
• 2-10 mcg/min

• PEDI
• 0.1-1 mcg/kg/min