EPINEPHRINE (ADRENALIN)

CLASS:

• Endogenous Catecholamine / Sympathomimetic

• Alpha and beta adrenergic (agonist)

ACTIONS:

• Causes positive inotropic, chronotropic,and dromotropic effects (beta effects)

• Peripheral vasoconstriction (alpha effect) which increases the coronary perfusion pressure

• Bronchial dilation

INDICATIONS:

• ACLS - refer to treatment algorithms (asystole, ventricular fibrillation, PEA, symptomatic brady)

• Bronchospasm, ie. asthma

• Anaphylaxis/allergic reaction to relieve bronchoconstriction and prevent further degranulation of mast cells

CONTRAINDICATION:

• Hypovolemic shock prior to fluid resuscitation

• Coronary insufficiency – worsen ischemia

• Hypertension

• May worsen tachycardias and certain dysrhythmias like VTach or PVCs

STANDARD PREP:

• 1 mg/10 cc preloaded syringe 1:10,000

• 1 mg/cc 1:1000

• 30 mg/30 cc multi-dose vial 1:1000 cc

DOSE/ROUTE:

• See Hawaii S.O. and ACLS Algorithm

PEDS DOSE:

• See Hawaii S.O. & PALS Algorithm

SIDE EFFECTS:

• Arrhythmia, tachycardia, hypertension, dilated pupils

• Nervousness, anxiety, tremor, headache, N & V

PRECAUTIONS:

• May increase myocardial oxygen demand as a result of tachycardia

• Inform RN of IV infiltration because can cause tissue sloughing-need phentolamine to counteract.

• Pts. on Beta Blockers may be resistant to Epi, or may have an increase in unopposed alpha effects

• Digoxin, sympathomimetics - increase risk of arrhythmia.