Paramedic Drug Facts: Epinephrine 1:10,000

Epinephrine 1:10,000 Trade Name: Adrenaline (Epinephrine) 1:10,000 Sterile Solution Minijet

Epinephrine 1:10,000 Medication Class: Sympathomimetic

Epinephrine 1:10,000 Pharmacokinetics:

• Onset: Subq – 5-10 min
• IV/ET Tube – 1-2 min
• Duration: 5-10 min

• Acute Allergic reaction
• Cardiac arrest
• Pulseless electrical activity
• V Fib and pulseless V Tach unresponsive to initial defibrillation
• Symptomatic bradycardia
• Severe hypotension accompanied by bradycardia when pacing and atropine fail
• Bronchial Asthma

• Hypersensitivity (not an issue in emergencies – the dose should be lowered or given slowly in non cardiac arrest patients with heart disease)
• Hypovolemic Shock (as with other catecholamines, correct hypovolemia 1st)
• Coronary Insufficiency (Use with Caution) 

Epinephrine 1:10,000 Cautions:

• MAO Inhibitors may potentate the effect of epinephrine
• Beta-adrenergic antagonists may blunt inotropic response
• Sympathomimetics and phosphodiesterase inhibitors may exacerbate dysrhythmia response
• May be deactivated by alkaline solutions (sodium bicarbonate, furosemide)

Parenteral: 0.1 mg/mL ampule and pre-filled syringe
Auto injector: 0.3 mg/mL

Epinephrine 1:10,000 Administration:

• Pulseless Arrest- Adult: IV/IO dose 1 mg(10 mL, 1:10,000) IV/IO push or ET Tube (2-2.5 mg diluted in 10 mL NS) Repeated every 3-5 min during resuscitation (Follow each IV dose with 20-mL saline flush); elevate arm for 20-30 sec after each dose; higher doses (up to 0.2 mg/kg) may be used for specific indications( ex: beta-blocker or calcium channel blocker overdose; poison/ drug induced shock)
• Pediatric: IV/IO dose: 0.01 mg/kg every 3-5 min during arrest; max-dose 1 mg
  All ET doses: 0.1 mg/kg of 1:1000 every 5 min of arrest until IV/IO access then begin with first IV/IO dose

• Headache
• Nausea and vomiting
• Restlessness
• Weakness
• Dysrhythmias, including V-tach and V-fib
• Hypotension
• Precipitation of angina pectoris
• Tachycardia
• Tremors
• Dyspnea