Medication of Allergies

Used in the emergency management of systemic allergic reactions or anaphylaxis (eg, urticaria, angioedema, bronchospasm, cardiovascular collapse). Effects are immediate and dramatic. Appropriate use of this class of medication can be lifesaving, especially in the emergency management of anaphylaxis.

Epinephrine (Adrenaline, EpiPen, TwinJect)

DOC for treating anaphylaxis. Helps decrease symptoms of anaphylaxis by increasing systemic vascular resistance, elevating diastolic pressure, producing bronchodilation, and increasing inotropic and chronotropic cardiac activity. In addition, helps reduce urticaria, angioedema, laryngeal edema, and other systemic manifestations of anaphylaxis.

Adult Dosing & Uses

Dosing Forms & Strengths

autoinjector

0.15mg

0.3mg

injectable solution

0.1mg/mL

1mg/mL

5mg/mL

Cardiac Arrest

0.5-1 mg IV q3-5min PRN OR

High dose: 1-5 mg IVP

ETT: 1 mg

Intracardiac: 0.1-1 mg

May follow initial dose with 1-4 mcg/min IV infusion (1:10,000 solution)

Asthma, Severe/Anaphylaxis

0.1-0.5 mg SC q10-15min, OR

0.1-0.25 mg IV (1:10,000 solution) over 5-10 minutes; may give IM (1:1000 solution), OR

Adrenaclick 0.3, EpiPen: 0.3 mg (contents of 1 autoinjector) SC/IM x 1; may repeat dose

Other Indications & Uses

Chronic glaucoma

Off-label: Stokes-Adams synd, hemostatic agent

Pediatric Dosing &Uses

Dosing Forms &Strengths

autoinjector

0.15mg

0.3mg

injectable solution

0.1mg/mL

1mg/mL

5mg/mL

IV drip: 0.1-1 mcg/kg/min IV

Asystole/Pulseless Arrest

1st dose (use 1:10,000 solution): 0.01 mg/kg IO/IV

Subsequent doses: Repeat above q3-5min

Consider higher dose (1:1000 solution): 0.1-0.2 mg/kg for special conditions

Neonates (<28 days old): 0.01-0.03 mg/kg q3-5min IV/IO/ET Symptomatic Bradycardia 1:10,000 solution: 0.01 mg/kg IO/IV Intratracheal: 0.1 mg/kg (1:1000 solution) Bronchodilator 1:1000 solution: 0.01 mg/kg SC q15min x3-4 doses or q4hr PRN Adrenaclick 0.15, EpiPen Jr. (weight <30 kg): 0.15 mg (contents of 1 autoinjector) SC/IM x 1; may repeat dose Adrenaclick 0.3, EpiPen (weight >30 kg): 0.3 mg (contents of 1 autoinjector) SC/IM x 1; may repeat dose

Nebulization

1:1000 solution diluted in 3 mL NS

<4 years old: 0.5 mg/kg via nebulizer; no more than 2.5 mL (2.5 mg)/dose >4 years old: 0.5 mg/kg via nebulizer; no more than 5 mL (5 mg)/dose