Epinephrine Dosage - is this too much?

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I am doing a care plan based on a patient with anaphalatic shock. When I looked at the his epinephrine, it was running at 20.0 mcg/min. The Davis Drug guide for Nurses says the safe dose is 1-4mcg/min continuous infusion. Have you guys ever heard of giving 20.0 mcg/min of epi?

Yeah, 20mcg/min is possible. I've run epi in excess of 80mcg/min.

Thanks for letting me know. I guess the "safe" dose isn't always the "effective" dose.

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Specializes in Cardiac.

I've run it at 50, 80, and even 100 mcgs. But those people were definitely on their way out.

However, the recommended dose, as per our pharmD is 1-10mcg.

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Specializes in Cardiac.
Dear Celclt, he had coded 3 times. He was on all kinds of drips. Neo, norepi, dopamine, vasopressin, nimbex, propofol, the works. I must be out of my mind to try to do a care plan on him, but I really would like to know how all these work together. Your explanation of the high dose of epi to over come other drugs makes perfect sense. This is the type of thing I really would like to under stand. . . . one day! Thanks for your input.

If he's on all those vasopressors then they need to nix the propofol. In fact, he's probably not waking up and bucking the vent at this stage. Plus, hopefully you don't have somebody on nimbex on not on fentanyl. Which they probably didn't. So I'd nix that as well. That's saves you the train of four need for appropriate sedation.

With a pH of 7, he isn't waking up.

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Dear Celclt, he had coded 3 times. He was on all kinds of drips. Neo, norepi, dopamine, vasopressin, nimbex, propofol, the works. I must be out of my mind to try to do a care plan on him, but I really would like to know how all these work together. Your explanation of the high dose of epi to over come other drugs makes perfect sense. This is the type of thing I really would like to under stand. . . . one day! Thanks for your input.

lol-you are welcome! You will understand it and do great! I had a really dynamic 1st sem teacher that was HUGE on sympathetic/ parasympathetic response- really understanding the why ( in pathophys,pharm) has helped me- it will help you to see the interventions needed.

I will say, I went nuts over care plans and learned from a fellow student the kiss -keeping it simple--REALLY made a big difference in seeing the big picture. Look to see what you can do as a RN to help pt, starting w ABCs down to Maslow's. Yes, this pt is on a ton of drips, why, what effect does this have on all systems, what need to be done to keep him safe, ect.

I have to do care maps too- do you? They are great IMO. Daytonite has one attached to her signature I believe, hth!

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