Name of Student: Anna Katrina B.

Velasco Year and Section: BSN3C DRUG STUDY

Date: July 17, 2012

Medication Generic Name: epinephrine (adrenaline) Epinephrine bitartrate Epinephrine Hydrochloride Brand Name: Bronkaid Mistormeter, Primatene Mist, AsthmaHaler Mist, Adrenalin Chloride, AsthmaNefrin, EpiPen, EpiPen Jr, Nephron, Vaponefrin Classification: adrenergic

Dosage, Route, Frequency Adults: 0.1 to 0.5 ml of 1:1,000 solution I.M. or subcutaneously. Repeat q10 to 15minutes, prn or, 0.1 to 0.25ml of 1:1,000 solution I.V. slowly over 5 to 10minutes May repeat q5 to 15minutes, prn or follow with a continuous I.V. infusion, starting at 1mcg/minute and increasing to 4mcg/minute prn. Children: 0.01ml/kg (10mcg) of 1:1,000 solution subcutaneously; repeat q20minutes to 4hrs, prn. Maximum single dose shouldnt exceed 0.5 mg. Adults: 1: 50, 000 to 1:1,000 sprayed or applied topically. Adults and children age 4 and older: One inhalation, repeated once if needed after at least 1 minute; dont give subsequent doses for at least 3hrs. Adults and children: With local anesthetics, may be used in concentrations of 1:500,000 to 1:50,000;

Mechanism of Action Relaxes bronchial smooth muscles by stimulating beta2 receptors and alpha and beta receptors in the sympathetic nervous system.

Indication Bronchospasm, hypersensitivity reaction, anaphylaxis Hemostatis Acute Asthma attacks To prolong anesthetic effect To restore cardiac rhythm in cardiac arrest

Contraindication Contraindicated in patients with angle closure glaucoma, shock (other than anaphylactic shock), organic brain damage, cardiac dilatation, arrhythmias, coronary insufficiency, or cerebral arteriosclerosis. Contraindicated in patients receiving general anesthesia with halogenated hydrocarbons or cyclopropane and in patients in labor (may delay second stage). Commercial products containing sulfites contraindicated in patients with sulfite allergies, except when epinephrine is being used to treat serious allergic reactions or other emergency situations. Contraindicated for use in fingers, toes. Ears, nose, or genitalia when use with local

Adverse Effects CNS: nervousness, tremor, drowsiness, dizziness, headache, weakness, cerebral hemorrhage, stroke, vertigo, pain disorientation, agitation, fear. CV: palpitations, ventricular fibrillations, shock, widened pulse pressure, hypertension, tachycardia, anginal pain, altered ECG (including decreased Twave amplitude). GI: vomiting, nausea, Respiratory: dyspnea Skin: urticaria, hemorrhage at injection site, pallor. Other: tissue necrosis.

Nursing Responsibilities In patients with Parkinson disease, drug increases rigidity and tremor. Drug interferes with tests for urinary catecholamine. One mg= 1ml of 1:1,000 solution or 10ml of 1:1,000 solutions. Epinephrine is drug of choice in emergency treatment of acute anaphylactic reactions. Alert: Avoid I.M. use of parenteral suspension into buttocks. Gas gangrene may occur because drug reduces oxygen tension of the tissues, encouraging growth of contaminating organisms. Massage site after I.M. injection to counteract vasoconstriction