high alert medication
Catecholamine
Sympathomimetic
PCP: Anaphylaxis
PCP: Severe bronchospasm
PCP: Severe croup
ACP: Cardiac arrest
ACP: Peri-arrest hypotension
ACP: Significant bradycardia
There are no absolute contraindications to EPINEPHrine use in life-threatening situations such as anaphylaxis. Caution should be used in patients with significant tachydysrhythmias, or in the context of hypothermia.
PCP: Anaphylaxis
PCP: Severe bronchospasm with impending respiratory arrest
ACP: Pre-arrest anaphylaxis or bronchospasm
ACP: Cardiac arrest
ACP: Peri-arrest hypotension
ACP: Significant bradycardia
PCP: Anaphylaxis
PCP: Severe bronchospasm with impending respiratory arrest
PCP: Severe croup
ACP: Cardiac arrest
ACP: Pre-arrest anaphylaxis
ACP: Peri-intubation resuscitation
EPINEPHrine acts on alpha- and beta-adrenergic receptors. Alpha-adrenergic activity produces vasoconstriction and reduces vascular permeability; beta-adrenergic activity results in bronchial smooth muscle relaxation, increased heart rate, and increased force of cardiac contraction. EPINEPHrine also inhibits histamine release.
When given intramuscularly or intravenously, EPINEPHrine has a very rapid time of onset, and a relatively short duration of action, which may necessitate repeat doses.
Common reactions to systemically administered EPINEPHrine include anxiety, tremor, dizziness, sweating, palpitations, headache, and nausea. Rapid increases in blood pressure and heart rate can occur.
Accidental injection of epinephrine into a digit, hands, or feet may result in a loss of blood flow to the area.
EPINEPHrine overdose may produce significantly elevated blood pressures and heart rates, which may in turn cause cerebral hemorrhage.
Warning: EPINEPHrine vials must be stored in specially-marked containers and never co-mingled with other medications in kits or bins. Inadvertent administration of EPINEPHrine to patients has the potential to cause serious harm or death.
Patients with underlying coronary artery disease may develop signs and symptoms of angina or myocardial ischemia. Caution should be exercised in these cases.
Arrhythmias can develop in patients taking antiarrhythmic medications. Beta-adrenergic blocking drugs can limit the effectiveness of EPINEPHrine’s bronchodilating and inotropic effects.