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What is the generic name for Epinephrine?
Epinephrine
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What is the brand name for Epinephrine?
Adrenalin
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What is the class for Epinephrine?
- Sympathomimetic
- Adrenergic
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What is the mechanism of action for Epinephrine?
- Alpha and Beta agonist
- Alpha -1 agonist
- Peripheral vasoconstriction increasing systemic vascular resistance
- Beta-1 agonist
- Positive inotrope
- Positive chronotrope
- Postivive dromotrope
- Reduces defribrillation threshhold
- Renin release from kidneys
- Beta -2 agonist
- Bronchial smooth muscle relaxation
- Skeletal vasculature dilation
- Block histamine release
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Indications and field use for Epinephrine?
- Cardiac arrest, all rythms (1st drug for dead people)
- Increases SVR increasing cerebral & myocardial perfusion pressure during CPR
- Positive dromotrope can increase success rate of defibrillation
- Positive dromotrope can increase electrical activity in heart in asytole
- Refractory bronchospasm not relieved with other medication
- Bronchial smooth muscle relaxation increases bronchial airway diameter
- Anaphylaxis
- Increased SVR increases blood pressure
- Peripheral vasoconstriction reduces edema
- Bronchial smooth muscle relaxation increases bronchial airway diameter
- Histamine release from mast cells inhibited
- Hypotension not relieved by other therapy
- Increased SVR increases blood pressure
- Positive chronotropic and inotropic effects increases cardiac output
- Croup
- Peripheral vasoconstrition reduces edema
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Dosage for Epinephrine?
Dosage via IV/IO, IM, Sub-Q, SVN, or ETT
- Cardiac arrest, all rhythms (for dead people)
- Epi 1mg of 1:10,000 IV push with 20cc NS flush q 3-5 minutes, no limit
- ETT route Epi 2mg of 1:1,000 diluted in syringe with 8cc
- Anaphylaxis
- Refractory bronchospasm
- Epi 0.3mg of 1:1,000 IM
- Infusion for hypotension
- Epi 1, 2, or 4mg 1:1,000 added to 250cc NS at 2-10mcg/min
- Use after other treatment
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Contraindications for Epinephrine?
- None for normal cardiac arrest
- Hyperthermia arrest (relative)
- Adult with pulse, age <35 (relative, patch)
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Drug interactions for Epinephrine?
- Potentiates with other sypathomimetics
- Reacts with alkaline solution such as sodium bicarbonate
- Beta blockers reduce effects
- MAOI's increase effects
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Side effects for Epinephrine?
- AMI/CHP
- Dysrhthmias
- Hypertension
- Anxiety
- Tremors
- N/V
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Onset of action for Epinephrine?
Seconds
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AZ drug box supply for Epinephrine?
- 8 x Epi 1mg in 10cc (1:10,000) prefilled syringes
- 2 x Epi 1mg in 1cc (1:1,000) ampule
- 1 x Epi 30mg in 30cc (1:1,000) multidose vial
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What is the generic name for Verapamil?
Verapamil HCL
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What is the brand name for Verapamil?
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What is the class for Verapamil?
Calcium channel blocker
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Mechanism of action for Verapamil?
- Blocks calcium channels in myocardial cell slowing influx of calcium ions
- Reduces force of contraction
- Slows heart rate
- Slows AV node conduction
- Slows ventricular response from atrial fibrillation/atrial flutter
- Interrupts reentry in SVT
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Indications and field use for Verapamil?
- Rapid ventricular response from A-Fib/A-Flutter
- Slows influx of calcium ions reducing ventricular response
- SVT refractory to Adenosine (no WPW)
- Slows influx of calcium ions reducing heart rate and interrupts reentry pathways
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Dosage for Verapamil?
All doses are VERY slow IV push over 2-5 minutes with the patient supine
Verapamil 2.5-5.0mg VERY slow IV push over 2-5 minutes. May repeat in 15-30 minutes with 5-10mg
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What are the contraindications for Verapamil?
- Wolf-Parkinson-White (WPW)
- Any wide QRS tachycardia
- Hypotension
- Cardiogenic shock
- Concurrent IV beta-blocker use
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Drug interactions for Verapamil?
- Hypotension potentiated by other calcium channel blockers or beta blockers
- Hypotension might be reversed by Calcium Chloride & IV fluids
- Calcium Chloride recommended as pretreatment if BP marginal
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What are the side effects for Verapamil?
- Hyoptension
- Bradycardia
- Heart block
- Cardiac arrest
- Cardiogenic shock/CHF
- Nausea / Vomiting
- Headache
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Onset of action for Verapamil?
1-3 minutes
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AZ drug box supply for Verapamil?
2 x Verapamil 5mg in 2cc vial
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