| DRUG | SUPPLIED | DOSE | COMMENTS |
|---|---|---|---|
| EPINEPHRINE INHALED (Paeds) (alternative to racemic epinephrine - not commercially available in Canada) Mechanism of action: Alpha and beta adrenergic agonist Ref: 51, 245 Last update: 2022-12-20 |
IV solution: 1 mg/mL, 30 mL vial Epinephrine topical solution (same strength as IV solution) can be used for inhalation but BCCH will use the IV solution for inhalation as per March 2010 PTN decision. |
Croup: 5 mL/dose (5mg/dose) via nebulizer up to Q1H **If >= 3 doses required within 2-3 hours, contact PICU medical staff** |
Tachyphylaxis can occur (decreased response with repeated doses). For upper airway obstruction (croup) to be administered by respiratory therapists (RT) or physician (MD). Registered nurse (RN) may administer if MD present. . If necessary, after verbal approval by MD, RN may initiate the epinephrine nebulizer prior to RT or MD arrival so as not to delay treatment. For lower airway obstruction (bronchiolitis) RNs may administer Patients should be assessed by MD or RT before and after administration. See on-line procedure (SHOP) for Aerosol Therapy using nebulizer Standard Prescription: epinephrine 2.5 to 5 mg (2.5 to 5 ml) inhaled via nebulizer Q__H PRN for ____ doses |