Epinephrine: Difference between revisions

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[[Category:Drugs]]
[[Category:Drugs]]
[[Category:Airway/Resus]]
[[Category:Airway/Resus]]
==Pressor==
===Indication===
*Anaphylaxis
===Primary Receptor===
*β1
*α1
*β2
===Relative Effects===
*↑↑↑HR
*↑↑↑SV
*↑↑↑SVR
*Bronchodilation (β2)
===Dosing===
*Dose-dependent effects:
*1-10 mcg/min - increase HR and SV
*10-20 mcg/min - increase SVR
===Rate of Titration===
*Q2-5 min
===Adverse Effects===
*Tachyarrhythmias
*Myocardial ischemia
*↑Serum lactate
*Splanchnic ischemia
===Notes===
*↑lactate occurs primarily from ↑glycolysis/glycogenolysis within skeletal muscles not tissue hypoperfusion
*Use with caution in pts with CAD
**However clinical trials have not demonstrated worsened outcomes

Revision as of 14:33, 20 December 2014

Concentration

  • Amount of solution in mL used to dilute 1,000mg of epinephrine
    • eg 1:10,000 = 1,000mg/10,000mL = 0.1mg/mL

Adult Dosing

Anaphylaxis

0.3-0.5mg of 1:1,000 IM

  • Consider glucagon 1-5mg IV if pt 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

Pediatric Dosing

See critical care quick reference for drug doses by weight.

See Also

Pressor

Indication

  • Anaphylaxis

Primary Receptor

  • β1
  • α1
  • β2

Relative Effects

  • ↑↑↑HR
  • ↑↑↑SV
  • ↑↑↑SVR
  • Bronchodilation (β2)

Dosing

  • Dose-dependent effects:
  • 1-10 mcg/min - increase HR and SV
  • 10-20 mcg/min - increase SVR

Rate of Titration

  • Q2-5 min

Adverse Effects

  • Tachyarrhythmias
  • Myocardial ischemia
  • ↑Serum lactate
  • Splanchnic ischemia

Notes

  • ↑lactate occurs primarily from ↑glycolysis/glycogenolysis within skeletal muscles not tissue hypoperfusion
  • Use with caution in pts with CAD
    • However clinical trials have not demonstrated worsened outcomes