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Epinephrine

(Science: drug) a cardiac drug used for cardiac arrest from ventricular fibrillation, ventricular tachycardia, asystole, or pulseless electrical activity; extreme hypotension; bradycardia and heart block.

pharmacologic action: 1. Beneficial mainly due to alpha stimulation - increases systemic vascular resistance and improves coronary and cerebral blood flow. 2. Value of beta stimulation is controversial - increases myocardial electrical activity and strength of contraction, but also increases myocardial oxygen requirements and automaticity.

Dose: cardiac arrest: Recommended: 1 mg iv push every 3-5 min Intermediate: 2-5 mg iv push every 3-5 min Escalating: 1 mg, 3 mg, 5 mg iv push 3 min apart High: 0.1 mg/kg iv push every 3-5 min.

continuous infusion for bradycardia and severe hypotension: 2 - 10 mcg/min.

epinephrine can be delivered via the endotracheal tube. Increase dose 2-2.5 times iv dose.

potential complications: hypertension and tachycardia, arrhythmias, especially ventricular ectopy, myocardial ischemia.

Synonym: adrenaline. a catecholamine secreted by the adrenal medulla in response to stress (trade name Adrenalin); stimulates autonomic nerve action.