Page 136 - 2023 SMOG Digital

EPINEPHRINE Lactation? (Caution)
1mg/10mL (formerly 1:10,000) Trade Name: Adrenalin
Class / Mechanism of Action
Alpha & Beta Agonist
Sympathomimetic, stimulates both alpha and beta adrenergic receptors, causing relaxation of the bronchial
tree, cardiac stimulation, and dilation of skeletal muscle blood vessels
Indications
• Cardiac Arrest (VF, pulseless VT, asystole, PEA)
• Drip-Dose: Bradycardia (Symptomatic), Fluid Resistant Shock
• Push-Dose: Bradycardia, Hypotension, Refractory Anaphylaxis
Contraindications
• Uncontrolled hypertension is a relative contraindication, otherwise none
Adverse Reactions / Precautions
• No applicable use in hemorrhagic shock unless fluid replacement therapy maximized!
Maximize use of Blood products/Crystalloids before considering use in hemorrhagic shock.
• Chest Pain, Tachycardia, Arrhythmias, Palpitations, Sudden death
• Anxiety, Cerebral Hemorrhage, Headache
• Vesicant: Avoid extravasation, will cause tissue damage/necrosis
• Use with caution in patients taking tricyclic antidepressants; effects of epinephrine may be increased
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Asystole/pulseless arrest, pulseless VT/VF: Asystole, PEA, pulseless VT/VF, Unresponsive
IV: 1mg/10mL (0.1mg/mL) Pre-filled 10cc Syringe and Symptomatic Bradycardia in Infants
• 1 mg (10cc of 0.1mg/mL) every 3-5 minutes to IV: 1mg/10mL – 0.1mg/mL Pre-filled 10cc Syringe
ROSC, Follow each with 20mL flush
• 0.01mg/kg (0.1 mL/kg of 1mg/10mL [0.1mg/mL])
Drip-Dose: Bradycardia (Symptomatic), Fluid (maximum single dose: 1mg) q3-5min as needed
Resistant Shock: or until ROSC
IV Continuous Infusion: Severe Hypotension/shock and fluid resistant
• 2-20 mcg/minute titrate to desired effect (HR (unlabeled use):
>60, MAP >65) IV: Continuous Infusion
Push-Dose: Bradycardia, Hypotension, • 0.1-1mcg/kg/minute titrated to desired effect
Refractory Anaphylaxis:
IV/IO: Mix 100mcg (1mL of 1mg/10mL) Epinephrine
in 10cc NS for concentration of 10mcg/mL
• 5-20mcg IV/IO push q2-5min, titrate to
desired response

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