- Stimulates beta adrenergic receptors
- increases myocardial contractility, positive chronotrope, positive dromotrope, bronchodilator
- used to treat bradycardias, severe left ventricular dysfunction or anaphylaxis
- Stimulates alpha adrenergic receptors
- used in profound hypotension or pulseless cardiac arrest to promote systemic perfusion pressure gradient
- Bolus dose:
- 1 mg IV direct (single IV doses of up to 10 mg have been used in EMD, ventricular fibrillation)
- Infusion dose:
- 1-4 mcg/min (beta dose) titrated to effect
- >20 mcg/min dose titrated to effect (alpha dose)
8 mg/250 mL D5W, NS, RL
- Protect from light
- Should be weaned off
- Hypovolemia, hypoxemia and acidosis should be corrected concurrently with initiation of therapy
- increased myocardial oxygen consumption
- increased blood glucose
- renal failure
- decreased mesenteric ischemia
- extravasation of drug may cause tissue necrosis (Rx with 5-15 mg phentolamine in NS - see phentolamine monograph)
- epinephrine + propranolol = increased BP, decreased HR --->may be fatal; OR propranolol may make patients resistant to epinephrine effects
- epinephrine + other sympathomimetics = increased toxicity
- epinephrine + inhaled anaesthetics = increased myocardial irritability and risk of arrhythmias
- HR, ECG
- cardiac index
- urine output
- blood glucose
- BUN, creatinine
- arterial lactate
- changes in skin temperature or color
- May be administered as 1mg IV direct without a physician's order by a certified nurse in the CCTC for pulseless ventricular tachycardia or ventricular fibrillation.
- May be titrated by an approved nurse in the CCTC.
- Must be administered via central line.
- Continous infusion must be administered via an infusion pump.
- Should not be infused via the proximal injectate port (blue) of the Swan Ganz catheter.
- Patient requires placement of an arterial line to monitor BP.