teedubbya wrote:From the PDR
That's for the EpiPen only, as it is clearly oversimplified.
Here... I can copy & paste too.
http://www.pdr.net/drug-summary/Adrenalin-epinephrine-3036
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Adrenalin (epinephrine)
THERAPEUTIC CLASS: Sympathomimetic catecholamine
DEA CLASS: RX
ADULT DOSAGE & INDICATIONS
Emergency Treatment of Type I Allergic Reactions
Includes anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances, and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis
0.3-0.5mg (0.3-0.5mL) of undiluted epinephrine IM/SQ; may repeat inj every 5-10 min as necessary
Max: 0.5mg (0.5mL)/inj
Ocular Surgery
Induction and Maint of Mydriasis During Intraocular Surgery:
1mL Vial:
Must be diluted prior to intraocular use
Dilute 1mL of epinephrine 1mg/mL (1:1000) in 100 to 1000mL of an ophthalmic irrigation fluid to create a concentration of 1:100,000 to 1:1,000,000 (10mcg/mL to 1mcg/mL); use the irrigating sol prn for the surgical procedure
After dilution in an ophthalmic irrigating fluid, may also be injected intracamerally as a bolus dose of 0.1mL at a dilution of 1:100,000 to 1:400,000 (10mcg/mL to 2.5mcg/mL)
PEDIATRIC DOSAGE & INDICATIONS
Emergency Treatment of Type I Allergic Reactions
Includes anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances, and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis
<30kg:
0.01mg/kg (0.01mL/kg) of undiluted epinephrine IM/SQ; may repeat inj every 5-10 min as necessary
Max: 0.3mg (0.3mL)/inj
≥30kg:
0.3-0.5mg (0.3-0.5mL) of undiluted epinephrine IM/SQ; may repeat inj every 5-10 min as necessary
Max: 0.5mg (0.5mL)/inj
Ocular Surgery
Induction and Maint of Mydriasis During Intraocular Surgery:
1mL Vial:
Must be diluted prior to intraocular use
Dilute 1mL of epinephrine 1mg/mL (1:1000) in 100 to 1000mL of an ophthalmic irrigation fluid to create a concentration of 1:100,000 to 1:1,000,000 (10mcg/mL to 1mcg/mL); use the irrigating sol prn for the surgical procedure
After dilution in an ophthalmic irrigating fluid, may also be injected intracamerally as a bolus dose of 0.1mL at a dilution of 1:100,000 to 1:400,000 (10mcg/mL to 2.5mcg/mL)
HOW SUPPLIED
Inj: 1mg/mL [1mL single-use vial, 30mL multi-dose vial]
WARNINGS/PRECAUTIONS
Not recommended for inj into or near muscles smaller than the vastus lateralis (eg, deltoid) due to possible differences in absorption. Do not repeat inj at the same site; may cause tissue necrosis. Do not inject into buttock; may not provide effective treatment of anaphylaxis and has been associated w/ development of gas gangrene. Do not inject into digits, hands, or feet; may result in loss of blood flow and tissue necrosis if accidentally injected into these areas. Rare cases of serious skin and soft tissue infections including necrotizing fasciitis and myonecrosis caused by Clostridia reported; do not inject into the buttock to decrease the risk of Clostridium infection. Caution in patients w/ hyperthyroidism, Parkinson's disease, diabetes mellitus (DM), or pheochromocytoma, or who are pregnant or elderly. Caution w/ heart disease; may precipitate/aggravate angina pectoris or produce ventricular arrhythmias. Contains sodium bisulfite; associated w/ corneal endothelial damage when used in the eye at undiluted concentrations (1mg/mL) and may also cause mild to severe allergic reactions including anaphylaxis or asthmatic episodes in susceptible individuals. 30mL Vial:
Not for ophthalmic use; contains chlorobutanol that may be harmful to the corneal endothelium. 1mL Vial:
Must be diluted before intraocular use.ADVERSE REACTIONS
Anxiety, apprehensiveness, restlessness, tremor, weakness, dizziness, sweating, palpitations, pallor, N/V, headache, respiratory difficulties.
DRUG INTERACTIONS
May cause additive effects w/ other sympathomimetics; coadminister w/ caution. Monitor for cardiac arrhythmias w/ cardiac glycosides, digitalis, diuretics, quinidine and other antiarrhythmics, or halogenated hydrocarbon general anesthetics (eg, halothane). Effects may be potentiated by TCAs (eg, imipramine), MAOIs, levothyroxine sodium, and certain antihistamines (eg, diphenhydramine, tripelennamine, dexchlorpheniramine). Cardiostimulating and bronchodilating effects are antagonized by β-blockers (eg, propranolol). Vasoconstricting and hypertensive effects are antagonized by α-adrenergic blocking drugs (eg, phentolamine). Ergot alkaloids may reverse pressor effects. Do not use to counteract circulatory collapse or hypotension caused by phenothiazines; may result in further lowering of BP.
PREGNANCY AND LACTATION
Pregnancy: Category C. Caution during labor and delivery; may result in uterine vasoconstriction, decreased uterine blood flow, and fetal anoxia.
Lactation: It is not known if epinephrine is excreted in human milk; caution in nursing.
MECHANISM OF ACTION
Sympathomimetic catecholamine; acts on α-adrenergic receptors and lessens the vasodilation and increased vascular permeability that occurs during anaphylaxis. Acts on β-adrenergic receptors, causing bronchial smooth muscle relaxation. Also may alleviate GI and genitourinary symptoms associated w/ anaphylaxis due to relaxer effects on smooth muscle of the stomach, intestine, uterus, and urinary bladder.
ASSESSMENT
Assess for sulfite sensitivity, heart disease, DM, hyperthyroidism, Parkinson's disease, pheochromocytoma, pregnancy/nursing status, and possible drug interactions.
MONITORING
Monitor for angina pectoris, ventricular arrhythmias, allergic reactions, serious skin and soft tissue infections, and other adverse reactions. Monitor for severity of the allergic reaction and potential cardiac effects of the drug.
PATIENT COUNSELING
Advise about the common adverse reactions of therapy and inform that these symptoms usually subside rapidly, especially w/ rest, quiet, and recumbent positioning. Warn patients w/ good response to initial therapy about the possibility of recurrence of symptoms and instruct to obtain proper medical attention if symptoms return. Warn diabetic patients that they may develop increased blood glucose levels following epinephrine administration. Instruct to seek immediate medical care if signs/symptoms of an infection develop at the inj site.
STORAGE
20-25°C (68-77°F). Protect from light and freezing. Discard vials 30 days after initial use.