high alert medication

Catecholamine

Sympathomimetic

FR: Anaphylaxis via autoinjector

⚠️ EMR: Requires completion of scope expansion education. Anaphylaxis

PCP: Anaphylaxis

PCP: Severe bronchospasm

PCP: Stridor (secondary to croup or other infectious cause)

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

Onset: 30-90 seconds (IM); 30 seconds (IV)

Peak: 4-10 minutes (IM); 3-5 minutes (IV)

Duration: 5-10 minutes (IM/IV)

• 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 rate, 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.

Caution should be used in patients with significant tachydysrhythmias or in the context of hypothermia.

Arrhythmias can develop in patients taking antiarrhythmic medications.  Beta-adrenergic blocking drugs can limit the effectiveness of EPINEPHrine’s bronchodilating and inotropic effects.