EPINEPHRINE

(ep-i-ne’frin)
Bronkaid Mist, Epi-E-Zpen, Epinephrine Pediatric, EpiPen Auto-Injector, Primatene Mist Suspension
EPINEPHRINE BITARTRATE
AsthmaHaler, Bronkaid Mist Suspension, Bronitin Mist Suspension, Epitrate, Medihaler-Epi, Primatene Mist Suspension
EPINEPHRINE HYDROCHLORIDE
Adrenalin Chloride, Bronkaid Mistometer, Dysne-Inhal, Epifrin, Glaucon, SusPhrine

NURSING IMPLICATIONS

Assessment & Drug Effects

• Monitor BP, pulse, respirations, and urinary output and observe patient closely following IV administration. Epinephrine may widen pulse pressure. If disturbances in cardiac rhythm occur, withhold epinephrine and notify physician immediately.
• Keep physician informed of any changes in intake-output ratio.
• Use cardiac monitor with patients receiving epinephrine IV. Have full crash cart immediately available.
• Check BP repeatedly when epinephrine is administered IV during first 5 min, then q3–5min until stabilized.
• Advise patient to report to physician if symptoms are not relieved in 20 min or if they become worse following inhalation.
• Advise patient to report bronchial irritation, nervousness, or sleeplessness. Dosage should be reduced.
• Monitor blood glucose & HbA1c for loss of glycemic control if diabetic.

Patient & Family Education

• Be aware intranasal application may sting slightly.
• Administer ophthalmic drug at bedtime or following prescribed miotic to minimize mydriasis, with blurred vision and sensitivity to light (possible in some patients being treated for glaucoma).
• Transitory stinging may follow initial ophthalmic administration and that headache and browache occur frequently at first but usually subside with continued use. Notify physician if symptoms persist.
• Discontinue epinephrine eye drops and consult a physician if signs of hypersensitivity develop (edema of lids, itching, discharge, crusting eyelids).
• Learn how to administer epinephrine subcutaneously. Keep medication and equipment available for home emergency. Confer with physician.
• Note: Inhalation epinephrine reduces bronchial secretions and thus may make mucous plugs more difficult to dislodge.
• Report tolerance to physician; may occur with repeated or prolonged use. Continued use of epinephrine in the presence of tolerance can be dangerous.
• Take medication only as prescribed and immediately notify physician of onset of systemic effects of epinephrine.
• Discard discolored or precipitated solutions.
• Do not breast feed while taking this drug without consulting physician.

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