Epinephrine

Epinephrine 1:1000

CLASS

Sympathomimetic, Vasopressor used in shock

DOSAGE

    Adult:0.3 mg (0.3 cc) IM.

    May be repeated every 15 minutes x 3 if patient in anaphylaxis if hypotensive, start an IV and administer 3 cc of a 1:10,000 solution slow IV.

    Pediatric:0.01 mg/kg up to 0.3 mg IM. Epinephrine (1:1000) is also given in a dosage of 0.1 mg/kg ET (max. 2 mg) as a cardiac agent.

ACTIONS

    Epinephrine is a sympathomimetic, which stimulates both alpha and beta-adrenergic receptors causing immediate bronchodilation, increase in heart rate and an increase in the force of cardiac contraction. Subcutaneous dose lasts 5-15 minutes.

-b1- contractility, inotropic, increase AV conduction, automaticity
-b2- bronchial dilation, skeletal muscle vasodilation
-a- peripherial vasoconstriction, fight or flight response

INDICATIONS

    - Asthma.
    - Anaphylaxis.
    - Acute bronchial spasms associated with asthma, COPD or croup.
    - Angioneurotic edema.
    - Asystole, V-Fib, pulseless VT, PEA
    -

CONTRAINDICATIONS

    Hyperthyroidism, hypertension, cerebral arteriosclerosis in asthma.

    Should not be administered in elderly or debilitated patients with underlying cardiovascular disease.

    In anaphylaxis, however, there are no contraindications.

WARNINGS

    Same as Epinephrine 1:10,000. Also causes hyperglycemia. With the exception of cardiac arrest, Epinephrine 1:1,000 should not be given intravenously; it should be diluted first (1 mg in 9 ml of NS = 1:10,000 or 1 mg / 10 ml).

SIDE EFFECTS

    Same as Epinephrine 1:10,000

Epinephrine 1:10,000

DOSAGE

    Adult:
    IV push (1:10,000) 1 mg (10 ml) IV, repeat every 3-5 minutes.

    ETT 1:1000, 2 mg in 10mls of NS q3 minutes

    As a pressor infusion 1 mg / 250 ml D5W, start 2 mcg / min and titrate.

    Pediatric:
    0.01 mg/kg, (0.1 ml/kg IV or IO), repeat every 3-5 minutes.

    Use Epinephrine (1:1000) 0.1 mg/kg (max. 2 ml) any time it is given ET.

Nebulizer Treatment
Adult:
0.3mg of 1:10,000 (3 mls.) in adult nebulizer @ 6 lpm. Use Caution: in patients over 45 or of possible cardiac history

Pediatric:
0.5mg of 1:10,000 (5 mls.) in adult mask nebulizer @ 6 lpm blow-by.

ACTIONS

    Epinephrine is a sympathomimetic, which stimulates both Alpha and Beta-receptors. As a result of the its effects, myocardial and cerebral blood flow are increased during ventilation and chest compression. Epinephrine increases systemic vascular resistance and thus may enhance defibrillation.

INDICATIONS

    Asystole, ventricular fibrillation unresponsive to defibrillation; PEA. Other pediatric indications hypotension in patients with circulatory instability, bradycardia (before Atropine).

CONTRAINDICATIONS

    None in the cardiac arrest situation.

WARNINGS

    Epinephrine is inactivated by alkaline solutions never mix with Sodium Bicarbonate. Do not mix isoproterenol and epinephrine, results is exaggerated response. Actions if catecholamines is depressed by acidosis, attention to ventilation and circulation is essential. Antidepressants potentiate the effects of epinephrine.

SIDE EFFECTS

    CNS:Anxiety, headache, cerebral hemorrhage.

    Cardio:Tachycardia, ventricular dysrhythmias, hypertension, angina,palpitations.

    GI:Nausea and vomiting.

Last Modified: 12/12/2013 - 21:21
Change in Dosage: Adult 10,000 per David Erdman.