Ephedrine Sulfate (Ephedrine)

Effects - increased cardiac output, heart rate, blood pressure, coronary blood flow, skeletal blood flow, uterine blood flow, and bronchodilation. Low blood pressure, low heart rate - Ephedrine is the 'go to' for most patients exhibiting a low blood pressure and low heart rate as it effectively raises both, and avoids the baroreceptor reflex (worsened bradycardia) that phenylephrine can produce. Effectiveness - Each dose given typically has a reduced effectiveness Oxidation - ephedrine is subject to oxidation when exposed to light. Do not use ephedrine if the solution is not clear. increased MAC - increases MAC of volatile anesthetic anesthetics Potential arrhythmias - when given to patients taking tricyclic antidepressants

Patients on MAOI therapy - use of ephedrine could lead to a hypertensive crisis Use caution: Patients with hypertension, tachycardia, ischemic heart disease, heart failure, depleted catecholamines

Hypotension & Bronchospasm: 2.5-10 mg intial dose, titrated every 5-10 minutes. MAX dose in 24 hours: 3mg/kg Common Preparations Method 1: 50 mg/ml vial.  Draw up 1 ml of ephedrine with 9 ml of crystalloid in a 10 ml syringe.  This dilutes to 5 mg/ml. Method 2: 50 mg/ml vial.  Draw up the 1 ml of ephedrine from the vial in a 1 ml TB syringe.  Each 0.1 mark represents 5 mg

25-50 mg

Ephedrine is a noncatecholamine sympathomimetic. Resistance to metabolism by monoamine oxidase and catechol-O-methyltransferase (COMT) makes ephedrine longer-lasting. Ephedrine works by direct/indirect simulation of alpha and beta adrenergic receptors. Stimulation of beta 2 receptors results in bronchodilation.

Hepatic

Renal