- Drug-induced hypotension (particularly in association with bradycardia)
Note: used commonly in Anaesthesia but of limited utility in the ICU setting
PRESENTATION AND ADMINISTRATION:
Ampoules contain 30mg in 1ml
Dilute 30mg to a total of 10ml using normal saline (giving a concentration of 3mg/ml) Store at room temperature
Protect from light
Compatible with the following IV fluids:
Normal saline, 5%dextrose, 10%dextrose, Glucose and sodium chloride, Hartmanns
Administer by direct IV injection of 3-9mg (1-3ml) and repeat as required
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
- Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
0.25-1mg/kg (max 5mg/dose)
- Ephedrine stimulates both alpha and beta receptors and its peripheral actions are due partly to norepinephrine release and partly to direct effect on receptors. Ephedrine may deplete norepinephrine stores in sympathetic nerve endings, so that tachyphylaxis to cardiac and pressor effects of the drug may develop.
- hypersensitivity to ephedrine
- Ephedrine may cause hypertension resulting in intracranial hemorrhage. Ephedrine may induce anginal pain in patients with coronary insufficiency or ischemic heart disease. The drug also may induce potentially fatal arrhythmias in patients with organic heart disease or who are receiving drugs that sensitize the myocardium
Ephedrine should be used cautiously in patients with hyperthyroidism, hypertension, heart disease (including coronary insufficiency, angina pectoris and patients receiving digitalis), cardiac arrhythmias, diabetes or unstable vasomotor system.
- Laboratory Tests:
No tests in addition to routine ICU tests are required.
- Drug/Laboratory Test Interactions:
IMPORTANT DRUG INTERACTIONS FOR THE ICU
- Ephedrine should not be administered concomitantly with other sympathomimetic drugs because of possible additive effects and increased toxicity. Alpha-adrenergic blocking agents may reduce the vasopressor response to ephedrine by causing vasodilation. Beta-adrenergic blocking drugs may block the cardiac and bronchodilating effects of ephedrine. Ephedrine also should be used cautiously with other drugs (e.g., digitalis glycosides) that sensitize the myocardium to the actions of sympathomimetic agents.
- Cardiovascular system:
Hypertension, tachyarrhythmias, palpitations
- Neurological system:
headache, restlessness, anxiety, tension, tremor, weakness, dizziness, confusion, delirium hallucinations
- Gastrointestinal system:
nausea or vomiting