Epinephrine: Difference between revisions
(Text replacement - "B-blocker" to "beta-blocker") |
ClaireLewis (talk | contribs) No edit summary |
||
| Line 6: | Line 6: | ||
**Amount of solution in mL used to dilute 1,000mg of epinephrine | **Amount of solution in mL used to dilute 1,000mg of epinephrine | ||
**eg 1:10,000 = 1,000mg/10,000mL = 0.1mg/mL | **eg 1:10,000 = 1,000mg/10,000mL = 0.1mg/mL | ||
*Common Trade Names: Adrenaline | *Common Trade Names: Adrenaline, EpiPen (IM autoinjector) | ||
==Adult Dosing== | ==Adult Dosing== | ||
| Line 34: | Line 34: | ||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
Revision as of 19:50, 10 November 2016
See critical care quick reference for drug doses by weight.
General
- Type: Vasopressors
- Dosage Forms:
- Concentration
- Amount of solution in mL used to dilute 1,000mg of epinephrine
- eg 1:10,000 = 1,000mg/10,000mL = 0.1mg/mL
- Common Trade Names: Adrenaline, EpiPen (IM autoinjector)
Adult Dosing
Anaphylaxis
0.3-0.5mg of 1:1,000 IM
- Consider glucagon 1-5mg IV if patient on beta-blockers and not responding to epi
Anaphylactic shock
0.1mg of 1:10,000 slow IV during 5 min, can start infusion of 1-4 mcg/min
Cardiac Arrest
1mg of 1:10,000 IVP
Quick Epi Drip
- Take your code-cart epinephrine (it does not matter if It is 1:1,000 or 1:10,000) and inject 1mg into a liter bag of NS. Final concentration is 1mcg/ml. Run at 1cc/min and titrate to effect.
Pediatric Dosing
See critical care quick reference for drug doses by weight.
Pressors
Dosing
- Dose-dependent effects:
- 1-10 mcg/min - increase HR and SV
- 10-20 mcg/min - increase SVR
Rate of Titration
- Q2-5 min
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
- Tachyarrhythmias
- Myocardial ischemia
- Increased serum lactate
- Splanchnic ischemia
- Digital EpiPen injection
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
Primary Receptor
- β1
- α1
- β2
Relative Effects
- ↑↑↑HR
- ↑↑↑SV
- ↑↑↑SVR
- Bronchodilation (β2)
Notes
- ↑lactate occurs primarily from ↑glycolysis/glycogenolysis within skeletal muscles not tissue hypoperfusion
- Use with caution in patients with CAD
- However clinical trials have not demonstrated worsened outcomes