Understanding Anesthesiology - The Global Regional Anesthesia ...

EPINEPHRINE
Class
Sympathomimetic. Epinephrine has many uses:
1) Inotropic support in the patient in cardiogenic shock.
2) Bronchodilation in status asthmaticus.
3) Treatment of allergic reactions.
4) Treatment of croup.
5) Resuscitation in cardiovascular collapse of any cause.
6) Prolongation of action of anesthetic solutions.
Mechanism of Action
Epinephrine is a direct-acting sympathomimetic. It
stimulates #- and &-adrenergic receptors resulting in a
wide range of effects attributable to the sympathetic
nervous system.
Elimination
Enzymatic degradation
Effects
CNS
Anxiety, headache, stroke
CVS
Hypertension, tachycardia, arrhythmias, angina, pulmonary
edema. Increased risk of ventricular arrhythmias is
seen when used with volatile anesthetics.
Respiratory
Bronchodilation
Misc.
Skin necrosis at site of injection, hyperglycemia, transient
hyperkalemia, followed by hypokalemia.
Dose
Cardiac arrest (adults): 0.5-1.0 mg IV q5min prn
Inotropic support (adults): 0.1-1.0 ug/kg/min
Anaphylaxis/severe asthma:
Adults: 0.1-0.5 mg SC/IM or 1-5 ug/kg IV prn
Children: 0.01 mg/kg SC/IM, maximum 0.5 mg
Onset
IV: immediate
SC/IM: 6-15 minutes
Duration
IV: 5-10 minutes
SC: 1-3 hours
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