Vasopressor / Inotrope

Epinephrine

α and β agonist (dose-dependent)

Mechanism: Low dose: β-predominant (inotropy, vasodilation). High dose: α-predominant.

Calculate dose for your patient

Enter weight (kg or lb). Always verify before administration.

Patient weight

Computed weight

70.0 kg · 154.3 lb

Anaphylaxis IM

0.70 mg

= 0.70 mL (1 mg/mL)

Exceeds typical adult max 0.5 mg — cap and reassess.

Anterolateral thigh, repeat q 5–15 min if needed.

ACLS arrest

0.70 mg

= 7.00 mL (0.1 mg/mL)

1 mg IV adult q 3–5 min in arrest.

Weight is saved on this device for the next calculator you open.

Full dose calculator

Onset

<1 min IV

Duration

5–10 min

Metabolism

MAO/COMT.

Dosing

Adult

Arrest: 1 mg IV/IO q3–5 min. Anaphylaxis: 0.3–0.5 mg IM q5–15 min. Infusion: 0.02–0.2 mcg/kg/min.

Pediatric

Arrest: 0.01 mg/kg (1:10,000) IV/IO. Anaphylaxis: 0.01 mg/kg IM (max 0.3 mg).

Indications

Cardiac arrest
Anaphylaxis
Severe bronchospasm
Cardiogenic shock

Contraindications

None in life-threatening situations

Side Effects

Tachyarrhythmia
Hyperglycemia
Lactic acidosis

Clinical Pearls

1IM lateral thigh is fastest extra-vascular route in anaphylaxis.

References & Further Reading

1
Textbook
Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.
2
GuidelineOpen source
Panchal AR, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for CPR and ECC. Circulation. 2020;142(16_suppl_2):S366-S468.
3
Textbook
Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.
4
Textbook
Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.