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Epinephrine HCL
Trade Name
Adrenaline
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Epinephrine HCL
Class
Sympathomimetic
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Epinephrine HCL
Mechanism of Action
- Direct acting alpha and beta agonist
- Alpha: bronchial, cutaneous, renal and visceral arteriolar vasoconstriction
- Beta 1: positive inotropic and chronotropic actions, increases automaticity
- Beta 2: bronchial smooth muscle relaxation and dilation of skeletal vasculature
- Blocks histamine release
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Epinephrine HCL
Indications
- Cardiac arrest
- Asystole/PEA
- VF/Pulseless VT
- Severe Bronchospasm
- Asthma
- Bronchiolitis
- Anaphylaxis
- Bradycardia (Infants/Children)
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Epinephrine HCL
Contraindications
- Hypertension
- Hypothermia
- Pulmonary edema
- Coronary insufficiency
- Hypovolemic shock
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Epinephrine HCL
Adverse Reactions
- Hypertension
- Dysrhythmias
- Pulmonary edema
- Anxiety
- Psychomotor agitation
- Nausea
- Angina
- Headache
- Restlessness
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Epinephrine HCL
Drug Interactions
- Potentiates other sympathomimetics
- Deactivated by alkaline solutions
- MAOIs may potentiate effects of epinephrine
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Epineprine HCL
How Supplied
- 0.1 mg/ml (1:1000) ampules
- 0.1 mg/ml (1:1000) vials (30mg multidose)
- 0.1 mg/ml (1:10,000) prefilled syringes 1mg/10ml
- Auto-injectors:
- EpiPen®: 0.3 mg (1:1000, 0.3ml)
- EpiPen Jr®: 0.15mg (1:2000, 0.3ml)
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Epinephrine HCL
Dosage and Administration
Adult
- Bronchospasm/Respiratory Distress/Allergic Reactions/Anaphylaxis:
- 0.15 -0.3 mg (0.15 -0.3 ml 1:1000) IM (Auto-Injector in MA)
- Cardiac: (Asystole/PEA, Ventricular Fibrillation/Ventricular Tachycardia): 1 mg (1:10,000) q. 3-5 minutes IV/IO if IV/IO access is unavailable
- Endotracheal: 2.0-5.0 mg (1:1,000) every 3-5 minutes in 10ml NS
- Bradycardia:
- Infusion mix 1 mg 1:1000 in 250ml NS yield 4 mcg/ml run @ 2-10 mcg/min
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Epinephrine HCL
Dosage and Administration
Pediatric
- Bronchospasm/Respiratory Distress/Allergic Reactions/Anaphylaxis: 0.15 -0.3 mg (0.15 mg-0.3 mg 1:1000) IM (Auto-Injector in MA)
- Croup: 5ml (1:1000) via nebulizer over 5-15 minutes
- Cardiac: (Asystole/PEA, Ventricular Fibrillation/Ventricular Tachycardia):
- Standard initial dose: 0.01 mg/kg (1:10,000, 0.1mL/kg) q. 3-5 min. IV/IO
- Bradycardia:
- IV/IO: Standard initial dose: 0.01 mg/kg (1:10,000, 0.1mL/kg) maximum single dose of 0.5 mg.
- Infusion mix 1 mg 1:1000 in 250ml NS yield 4 mcg/ml run @ 0.1-1.0 mcg/kg/min
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Epinephrine HCL
Duration of Action
- Onset: Immediate
- Peak Effects: Minutes
- Duration: Several minutes
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Epinephrine HCL
Special Considerations
Pregnancy safety: Category C
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