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Understanding Anesthesiology - The Global Regional Anesthesia ...

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Epinephrine<br />

Class<br />

Sympathomimetic. Epinephrine has many uses:<br />

1) Inotropic support in the patient in cardiogenic shock.<br />

2) Bronchodilation in status asthmaticus.<br />

3) Treatment of allergic reactions.<br />

4) Treatment of croup.<br />

5) Resuscitation in cardiovascular collapse of any cause.<br />

6) Prolongation of action of anesthetic solutions.<br />

Mechanism of Action<br />

Epinephrine is a direct-acting sympathomimetic. It stimulates #- and &-adrenergic receptors<br />

resulting in a wide range of effects attributable to the sympathetic nervous system.<br />

Dose<br />

Cardiac arrest (adults): 0.5-1.0 mg IV q5min prn<br />

Inotropic support (adults): 0.1-1.0 ug/kg/min<br />

Anaphylaxis/severe asthma:<br />

Adults: 0.1-0.5 mg SC/IM or 1-5 ug/kg IV prn<br />

Children: 0.01 mg/kg SC/IM, maximum 0.5 mg<br />

Onset<br />

IV: immediate<br />

SC/IM: 6-15 minutes<br />

Duration<br />

IV: 5-10 minutes<br />

SC: 1-3 hours<br />

Elimination<br />

Enzymatic degradation<br />

Effects<br />

CNS<br />

Anxiety, headache, stroke<br />

CVS<br />

Hypertension, tachycardia, arrhythmias, angina, pulmonary edema. Increased risk of ventricular<br />

arrhythmias is seen when used with volatile anesthetics.<br />

Respiratory<br />

Bronchodilation<br />

Misc.<br />

Skin necrosis at site of injection, hyperglycemia, transient hyperkalemia, followed by hypokalemia.<br />

Related Glossary Terms<br />

Autonomic nervous system, Ephedrine Sulfate, Phenylephrine, Shock, Sympathetic nervous<br />

system<br />

Index<br />

Find Term<br />

Chapter 3 - <strong>Regional</strong> <strong>Anesthesia</strong><br />

Chapter 6 - Drug Finder<br />

Chapter 6 - Vasoactive Agents

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