Epinephrine (Intramuscular) Clinical Protocols 2026

Vocabulary-style flashcards covering the 2026 clinical intervention protocols for intramuscular Epinephrine, including dosages, indications, and pharmacokinetics.

Epinephrine Presentation

$1\,mg/ml$ ($1:1000$)

Administration Condition: Anaphylaxis

Clinical picture of an anaphylactic reaction with no contraindications.

Administration Conditions: Bronchoconstriction

Must meet three criteria: Clinical picture of bronchoconstriction, Asthmatic < 40\,years, and clinical picture of respiratory failure.

Protocol for Refractory Respiratory Distress

If the only sign of respiratory failure is refractory respiratory distress, consider Epinephrine only after three treatments of salbutamol/ipratropium.

Contraindication for Bronchoconstriction

Known coronary artery disease (MCAS - Maladie coronarienne).

Epinephrine Dosage (Weight < 25\,kg)

$0.15\,mg$ ($0.15\,ml$)

Epinephrine Dosage (Weight $\ge 25\,kg$ to $49\,kg$)

$0.3\,mg$ ($0.3\,ml$)

Epinephrine Dosage (Weight $\ge 50\,kg$)

$0.5\,mg$ ($0.5\,ml$)

Epinephrine Repetition for Anaphylaxis

Every $5\,minutes$ if the patient deteriorates, or every $10\,minutes$ if there is no improvement or indications persist; no maximum dose.

Epinephrine Repetition for Bronchoconstriction

A single dose only is administered with no repetition permitted.

Common Adverse Effects

Nervousness, tremors, anxiety, dizziness, headache, nausea, vomiting, pallor, tachycardia, palpitations, hyperglycemia, and dyspnea.

Rare Adverse Effects

Respiratory distress, cerebral hemorrhage, stroke (AVC), arrhythmia, hypertension (HTA), and angina/infarction.

Anaphylaxis with Cardiac Arrest (ACR) Protocol

Administer a single IM dose as soon as possible without interrupting or delaying CPR (RCR) and ventilation, regardless of prior doses.

Pharmacological Class of Epinephrine

Sympathomimetic amine

Onset of Action (IM)

$5$ to $10\,minutes$ for vasopressive and bronchodilation effects.

Epinephrine Half-life

$2$ to $3\,minutes$

Maximum Duration of Effect

$1$ to $4\,hours$

Epinephrine Metabolism and Elimination

Metabolized hepatically and peripherally; elimination is renal.