Epinephrine: Difference between revisions
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==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