Epinephrine

Generic Name

Epinepherine

Trade Name

Adrenaline

Classification

Natural catecholamine, sympathomimetic

Packaged

1mg/1mL (1:1000 solution) ampule Epi-Pen Auto injector (0.3mg)

Pharmacological Action

Stimulates alpha and beta-adrenergic receptors. Its alpha-receptor activity is most potent. Beta2 agonist; causes bronchodilation and dilation of vessels in skeletal muscles

Clinical Action

Beta2 effects: bronchodilation

Onset

3-10mins IM

Peak

20 mins IM

Duration

20-30 mins IM

Indications

Anaphylactic shock; severe bronchospasm in status asthmaticus after albuterol/atrovent

Contraindications

tachydysrythmias, hypertension, ventricular irritablility, CVD, pulmonary edema

Side effects: Cardiovascular

tachydysrythmias, precipitation of angina or MI, palpitations, hypertension

Side Effects: CNS

Anxiety, tremor, nervousness, headache

Side Effects: Other

Pupil dilation, nausea/ vomiting

Interactions

Use with tricyclic antidepressants (TCAs) and antihistamines my cause adverse cardiac effects

Adult Dosage

Anaphylaxis: 0.3mg IM

Pediatric Dosage: Anaphylaxis

0.01mg/kg (1:1000) SQ or IM to a maximum dose of 0.3mg

May repeat every 20 mins

Pediatric Dosage: Respiratory Distress/Failure

0.01mg/kg SQ maximum single dose 0.3mg

May repeat every 20 mins

Special Considerations

Message area after subcutaneous injection to counteract possible vasoconstriction. Monitor VS and cardiac monitor frequently and watch for developing arrhythmias if given for anaphylaxis. If patient is >40, has an irregular heart rate, has a heart rate >150, or has a history of heart disease or hypertension, contact medical control prior to administration