epinephrine

Sympathomimetic

1:1,000 (1mg of epi in 1ml or 1mg/ml)

1:10,000 (1mg of epi in 10ml or 0.1mg/ml)

• 1) Naturally occuring catecholamine that acts directly on the alpha and beta (more profound) adrenergic receptors.
• 2) This causes positive inotropic, dromotropic and chronotropic effects
• 3) Increases systemic vascular resistance and BP

• 1) Caridac arrest: asystole, VF, pulseless VT, PEA
• 2) Symptomatic bradycardia
• 3) Anaphylaxis
• 4) Severe reactive airway disease

Hypersensitivity to sympathomimetic amines

(*amine - class of compounds derived from ammonia by replacement of one or more H atoms with organic groups)

• 1) Protect from light
• 2) Can be deactivated by sodium bicarb, flush line between admin of epi and sodium bicarb
• 3) Effects intensified by antidepressants

• 1) Increases myocardial oxygen demand
• 2) Can cause; anxiety, H/A, CVA
• 3) Syncope, HTN, tachydysrhythmias
• 4) Tissue necrosis with repeated injections or extravasation of IV

• 1) May increase hypotension caused by phenothiazines, alpha and beta blockers.
• 2) Can be deactivated in alkaline solutions or sodium bicarb

• Cardiac Arrest:
• Adult: 1.0 mg 1:10,000 IVP q 3-5 mins or 2.0-2.5 mg ET q 3-5 mins of 1:1,000 (diluted to 10ml)
• Pedi: 0.01mg/kg of 1:10,000 IV/IO or 0.1 mg/kg of 1:1,000 ET q 3-5 min (diluted to 3-5ml)

• Severe Anaphylaxis/Asthma:
• Adult: 0.3-0.5mg SQ of 1:1,000 q 5-15 mins
• if ineffective give:
• 0.1-0.5mg of 1:10,000 IVP q 5-15 min

• Pedi: 0.01mg/kg of 1:1,000 SQ
• if ineffective give:
• 0.01mg/kg of 1:10,000 IVP q 5-15 mins

• Symptomatic Bradycardia Infusion:
• Preparation: 1mg of 1:1,000 in 250 ml NS
• Adult: 2-10 mcg/min

Pedi: 0.1-1 mcg/kg/min