| Epinephrine | |||||||||||
| Adrenergic catecholamine, beta 1 and 2 agonist causing increased levels of cAMP which causes bronchodilation, cardiac and CNS stimulation. Large doses cause vasoconstriction while small doses can cause vasodilation via beta-2 mediated action on vascular receptors. | |||||||||||
| Indications: Many in EMS settings. Anaphylaxis, severe asthma/RAD, pulseless electrical activity (PEA), asystole, ventricular fibrillation/pulseless ventricular tachycardia, symptomatic bradycardia, newborn resuscitation, |
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| Common Side Effects: Tremors, anxiety, dizziness, palpitations, dysrhythmias, anorexia, nausea, vomiting, dyspnea. Potentially Lethal Side Effects: Cerebral hemmorhage. |
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| Contraindications: Hypersensitivity to sympathomimetics, narrow angle glaucoma, nonanaphylactic shock during general anesthesia, labor, cardiac dilation, conornary insufficiency, cerebral arteriosclerosis, organic heart disease. |
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| Adult dosing: Allergic reaction/Anaphylaxis/Asthma/RAD SQ/IM: 0.3mg of 1:1000 for moderate-severe condition q 10-20 min, prn PEA/Asystole/VFib/PVT IV Push: 1mg of 1:10,000 q 3-5 min |
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| Pediatric dosing*: Symptomatic Bradycardia IV/IO bolus 0.01mg/kg of 1:10,000 ETT bolus 0.1mg/kg of 1:1,000 Allergic reaction/Anaphylaxis/Asthma/RAD SQ/IM: 0.01mg/kg of 1:1,000 to Max 0.3mg q 10-20 min, as indicated. PEA/Asystole/VFib/PVT IV/IO bolus 0.01mg/kg of 1:10,000 ETT bolus 0.1mg/kg of 1:1,000 Infusion follows recovery of perfusing rhythm: Begin at 0.1mcg/kg/min, adjust to effect, or Max 1mcg/kg/min |
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| Notes: - Use with caution in patients with suspected myocardial ischemia. |
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