Epinephrine
Class
Sympathomimetic
Description
Epinephrine stimulates alpha, beta-1, and beta-2 adrenergic receptors in
dose-related fashion. It is the initial drug of choice for treating broncho
constriction and hypotension resulting from anaphylaxis as well as all forms of
cardiac arrest. It is useful in managing reactive airway disease, but
beta-adrenergic agents are often used initially because of their bronchial
specificity and oral inhalation route. Rapid injection produces a rapid increase
in systolic pressure, ventricular contractility, and heart rate. In addition,
epinephrine causes vasoconstriction in the arterioles of the skin, mucosa, and
splanchnic areas and antagonizes the effects of histamine.
Onset & Duration
Onset: (SQ) 5-10 min.; (IV) 1-2 min.
Duration: 5-10 min.
Indications
1. Bronchial asthma
2. Acute allergic reaction
3. Cardiac arrest
4. Asystole
5. Pulseless electrical activity
6. Ventricular fibrillation unresponsive to initial defibrillatory attempts
Contraindications
1. Hypersensitivity
2. Hypovolemic shock
3. Narrow angle glaucoma
Adverse Reactions
1. Headache
2. Nausea
3. Restlessness
4. Weakness
5. Dysrhythmias
6. Hypertension
7. Precipitation of angina pectoris
Drug Interactions
1. MAO inhibitors and bretylium may potentiate the effect of epinephrine.
2. Beta-adrenergic antagonists may blunt inotropic response.
3. Sympathomimetics and phosphodiesterase inhibitors may exacerbate dysrhythmia
response.
4. May be deactivated by alkaline solutions (sodium bicarbonate, furosemide).
Special Considerations
1. Pregnancy safety: Category C
2. Syncope has occurred after epinephrine administration to asthmatic children.
3. May increase myocardial oxygen demand.
**Maybe given endotracheally
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