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Mechanism of action
Directing-acting alpha- and beta-agonist. Alpha vasoconstriction. Beta-1 postive intropic, chronotropic, and dromotropic effects. Beta-2 bronchial smooth muscle relaxation and dilation of skeletal vasculature.
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Indications
Cardiac arrest (V fib/pulseless V-tach, asystole, PEA), symptomatic bradycardia as an alternative infusion to dopamine severe hypotension secondary to bradycardia when atropine and transcutaneous pacing are unsuccessful, allergic reactions, anaphylaxis, asthma.
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Contraindications
Hypertension, hypothermia, pulmonary edema, myocardial ischemia, hypovolemic shock.
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Adverse reactions
Hypertension, tachycardia, arrhythmias, pulmonary edema, anxiety, restlessness, psychomotor agitation, nausea, headache, angina.
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Drug interactions
Potentiates other sympathomimetics, deactivated by alkaline solutions (ie, sodium bicarbonate) , monamine oxidase inhibitors (MAOIs) may poteniate effects, beta blockers may blunt effects.
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How supplied
1:1000 solution : ampules and vials containing 1mg/ml. 1:10,000 solution: prefilled syringes containing 1 mg in 10 ml (0.1 mg/ml). Auto-injector (EpiPen): 0.5mg/ml (1:2,000).
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Dosage and adminstration
Adult: Mild allergic reactions and asthma: 0.3-0.5mg (0.3-0.5 ml of 1:1000) SC. Anaphylaxis ).1 mg(1 ml of 1:10,000) IV/IO over 5 minutes. Cardiac arrest: IV/IO dose: 1mg (10ml 1:10,000 solution) every 3-5minutes during resucitation.
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