A Drug Study on
EPINEPHRINE
In Partial Fulfillment of the Requirements in
NCM 109 – RLE
Care of Mother, Child at Risk or With Problems
Submitted to:
Mr. Lendell Kelly B. Ytac, RN
Clinical Instructor
Submitted by:
Clint S. Ancog
BSN – 2A
Generic Name: epinephrine
Brand Name: Adrenalin
Drug Class: sympathomimetic agents
What is Epinephrine?
Epinephrine is a sympathomimetic catecholamine. The chemical name of
epinephrine is: 1,2-Benzenediol, 4-[(1R)-1-hydroxy-2-(methylamino)ethyl]-, or (-)-3,4-
Dihydroxy-α-[2(methylamino)ethyl]benzyl alcohol. Epinephrine solution deteriorates
rapidly on exposure to air or light, turning pink from oxidation to adrenochrome and
brown from the formation of melanin.
Dose
Anaphylaxis
Adults and Children 30 kg (66 lbs) or more
0.3 to 0.5 mg (0.3 to 0.5 mL) of undiluted Adrenalin administered
intramuscularly or subcutaneously in the anterolateral aspect of the thigh, up
to a maximum of 0.5 mg (0.5 mL) per injection, repeated every 5 to 10
minutes as necessary. Monitor clinically for reaction severity and cardiac
effects.
Children less than 30 kg (66 lbs)
0.01 mg/kg (0.01 mL/kg) of undiluted Adrenalin administered intramuscularly
or subcutaneously in the anterolateral aspect of the thigh, up to a maximum of
0.3 mg (0.3 mL) per injection, repeated every 5 to 10 minutes as necessary.
Monitor clinically for reaction severity and cardiac effects.
Hypotension Associated with Septic Shock
Dilute 1 mL (1 mg) of epinephrine from its vial to 1,000 mL of a 5 percent
dextrose or 5 percent dextrose and sodium chloride solution to produce a 1
mcg per mL dilution. Administration in saline solution alone is not
recommended. If indicated, administer whole blood or plasma separately
Indications
Anaphylaxis
Acute asthma attack
Bronchodilation
Chronic simple glaucoma
Hypersensitivity reaction
Prolong local anesthetic effects
Restore cardiac rhythm in cardiac arrest
Contraindications
Hypersensitivity to drug its components or sulfites
Angle-closure glaucoma
Cardiac dilatation, cardiac insufficiency
Cerebral arteriosclerosis, organic brain syndrome
Shock with use of general anesthetics and halogenated hydrocarbons or
cyclosporine
MAO inhibitor use within past 14 days
Labor
Breastfeeding
Side Effects
Anxiety
Apprehensiveness
Restlessness
Tremor
Weakness
Dizziness
Sweating
Palpitations
Pallor
Nausea and Vomiting
Headache
Respiratory Difficulties
Adverse Side Effects
Cardiovascular: angina, arrhythmias, hypertension, pallor, palpitations,
tachyarrhythmia, tachycardia, vasoconstriction, ventricular ectopy
and stress cardiomyopathy. Rapid rises in blood pressure associated with
epinephrine use have produced cerebral hemorrhage, particularly in elderly
patients with cardiovascular disease
Neurological: disorientation, impaired memory, panic, psychomotor agitation,
sleepiness, tingling.
Psychiatric: anxiety, apprehensiveness, restlessness.
Patients with Parkinson's disease may experience psychomotor agitation or a
temporary worsening of symptoms.
Diabetic patients may experience transient increases in blood sugar.
Drug Interaction
Antagonizing Pressor Effects of Epinephrine
Vasodilators, such as nitrates
Diuretics
Antihypertensives
Ergot alkaloids
Phenothiazine antipsychotics
Potentiating Pressor Effects of Epinephrine
Sympathomimetics
β-blockers, such as propranolol
Tricyclic anti-depressants
Monoamine oxidase (MAO) inhibitors
Catechol-O-methyl transferase (COMT) inhibitors, such as entacapone
Clonidine
Doxapram
Oxytocin
Nurse Responsibilities
1. Evaluate the drug's impact on the underlying issue (such as anaphylaxis or an
asthma attack), and repeat the dose as required.
2. Keep track of fluid intake and output, looking for signs of urinary retention or
reduced output.
3. Check for hemorrhage or skin necrosis at the injection site.
4. Instruct auto-injector patients how to properly use the syringe, when to
administer the medication, and when to repeat doses.
5. Instruct a patient who utilizes a hand-held nebulizer how to properly use the
device and the medication. Demonstrate the indications for the first and
subsequent doses.
6. Discuss the importance of timely assessment by a health care provider unless
the patient will self-administer the medication outside of the health care
environment to ensure that the underlying condition has been corrected.
7. Review any other serious and life-threatening adverse reactions and
interactions, particularly those related to the drugs and tests listed above, as
needed.
References
RxList. (2019). Adrenalin. Retrieved from: https://www.rxlist.com/adrenalin -drug.
htm#description
