Epinephrine: Difference between revisions
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===Quick Epi Drip=== | ===Quick Epi Drip=== | ||
*Take your code-cart epi (it doesn't matter if | *Take your code-cart epi (it doesn't 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== | ==Pediatric Dosing== |
Revision as of 08:21, 13 July 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
Adult Dosing
Anaphylaxis
0.3-0.5mg of 1:1,000 IM
- Consider glucagon 1-5mg IV if patient on B-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 epi (it doesn't 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:
- Lactation:
- 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