Epinephrine (EpiPen) Nursing Considerations

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Kara Tarr
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Drug Card Epinephrine (Epipen) (Cheatsheet)
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Outline

Generic Name

Epinephrine

Trade Name

Adrenalin, EpiPen

Indication

Asthma and COPD exacerbations, allergic reactions, cardiac arrest, anesthesia adjunct

Action

Affects both beta1 and beta2 also has alpha agonist properties resulting in bron-
chodilation and increases in HR and BP. Inhibits hypersensitivity reactions.

Therapeutic Class

Antiasthmatic, bronchodilator, vasopressor

Pharmacologic Class

Adrenergic agonist

Nursing Considerations

• Side effects include: angina, tachycardia, hypertension, restlessness,
nervousness, hyperglycemia
• Use with MAOI may lead to hypertensive crisis
• Patients should not use stimulants (caffeine, guarana, etc)
• Excessive use may cause bronchospasm
• Assess lung sounds, pulse, BP, and other hemodynamic parameters
• Monitor for chest pain
• Instruct patient to use as directed
• Patient should insure adequate fluid intake to liquefy secretions
• Mouth should be rinsed after inhalation
• Beta blockers may negate effects
• May increase blood glucose levels

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Transcript

Hey guys, let’s talk about epinephrine or adrenaline also known sometimes as an EpiPen. This is an injectable medication. As you can see here, I took this picture at work. I work in surgery and we actually use epinephrine quite a bit in surgery. So remember when we talk about the therapeutic class of a medication, this is how the drug works in the body. While the pharmacologic class is the chemical effect. So for epinephrine, it’s therapeutic class is antiasthmatic, it’s a bronchodilator, and a vasopressor while the pharmacologic class is an adrenergic agonist. So epinephrine affects both beta-1 and beta-2 receptors in an agonistic fashion. And it also has alpha agonist properties. The action of epinephrine results in bronchodilation. It increases heart and blood pressure, and it also inhibits hypersensitivity reactions. So we use epinephrine for asthma and COPD exacerbations for allergic reactions, cardiac arrest, and as an adjunct to anesthesia.
So, because epinephrine works on the beta-1 and beta-2 receptors, it has a potential to create a few side effects, which can include angina, tachycardia, hypertension, and nervousness. So let’s take a look at a few nursing considerations for epinephrine. Be sure to assess your patient’s lung sounds, blood pressure, and pulse during therapy, monitor your patient for chest pain. Epinephrine may cause increased blood glucose levels and bronchospasms with excessive use. Beta blockers can prevent the effects of epinephrine and epinephrine with an MAOI can cause a hypertensive crisis. Be sure to teach your patient not to use any stimulants with epinephrine, including coffee, and also they should take in enough fluid to liquify secretions and rinse their mouth after an inhalation if nebulized epinephrine is being used. Epinephrine, when possible, should really be given through a central line because it can cause skin necrosis, and should only be given peripherally while another line is being established. So if skin necrosis occurs in your patient, epinephrine should most definitely it be stopped. That’s it for epinephrine or adrenaline or EpiPen. Now go out and be your best self today. And as always happy nursing.

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CVOR

Concepts Covered:

  • Cardiac Disorders
  • Cardiovascular
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock
  • Shock
  • Adult
  • Medication Administration
  • Vascular Disorders
  • Newborn Complications
  • Noninfectious Respiratory Disorder
  • Eating Disorders
  • Intraoperative Nursing
  • Cardiovascular Disorders
  • Terminology
  • Pregnancy Risks
  • Urinary System
  • Upper GI Disorders
  • Studying
  • Disorders of Pancreas
  • Communication
  • Perioperative Nursing Roles
  • Substance Abuse Disorders
  • Acute & Chronic Renal Disorders
  • Pediatric
  • Respiratory Emergencies
  • Postoperative Nursing
  • Emergency Care of the Respiratory Patient
  • Neurological Emergencies
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

02.02 Cardiomyopathy for CCRN Review
02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.14 Shock Stages for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
ACE (angiotensin-converting enzyme) Inhibitors
ACLS (Advanced cardiac life support) Drugs
Acute Coronary Syndrome (ACS)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Adenosine (Adenocard) Nursing Considerations
Advanced Cardiovascular Life Support (ACLS)
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Angiotensin Receptor Blockers
Arterial Pressure Monitoring
Aspiration for Certified Emergency Nursing (CEN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Blood Flow Through The Heart
Blood Pressure (BP) Control
Calcium Channel Blockers
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Cardiac (Heart) Enzymes
Cardiac (Heart) Physiology
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Course Introduction
Cardiac Cycle
Cardiac Glycosides
Cardiac Labs – What and When to Use Them – Live Tutoring Archive
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
Cardiac Stress Test
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac Terminology
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
Coronary Artery Disease Concept Map
Digoxin (Lanoxin) Nursing Considerations
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Echocardiogram (Cardiac Echo)
Electrical A&P of the Heart
Electrical Activity in the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
Endocarditis for Certified Emergency Nursing (CEN)
Epinephrine (EpiPen) Nursing Considerations
General Anesthesia
GERD (Gastroesophageal Reflux Disease)
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hemodynamics
Hiatal Hernia
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hypovolemic and Distributive Shock for Certified Emergency Nursing (CEN)
Interdisciplinary Team Participation for Certified Perioperative Nurse (CNOR)
Intraoperative Positioning
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
MI Surgical Intervention
Midazolam (Versed) Nursing Considerations
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Mixed (Cardiac) Heart Defects
Myocardial Infarction (MI) Case Study (45 min)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Obstructive Heart (Cardiac) Defects
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Pacemakers
Pediatric Advanced Life Support (PALS)
Performing Cardiac (Heart) Monitoring
Pericardial Tamponade for Certified Emergency Nursing (CEN)
Pleural Effusion for Certified Emergency Nursing (CEN)
Post-Anesthesia Recovery
Preload and Afterload
Premature Ventricular Contraction (PVC)
Product Evaluation and Selection for Certified Perioperative Nurse (CNOR)
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Sepsis Labs
Sinus Bradycardia
Sinus Tachycardia
Supraventricular Tachycardia (SVT)
The Heart
Thrombolytics
Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)
Troponin I (cTNL) Lab Values
Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Vasopressin
Ventilator Settings
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)