DRUG SUPPLIED DOSE COMMENTS
EPINEPHRINE MDI (Paeds)
(Primatene)

Mechanism of action:

Alpha and beta adrenergic agonist, vasoconstrictor.



Ref: 126, 159, 541


Last update: 2021-07-20		 Metered Dose Inhaler (MDI):  125 mcg/puff
ED/PICU/ Infant Transport Team (in the field):

5 puffs inhaled (with spacer) q10 minutes PRN for stridor
Maximum: 15 puffs in 60 minutes
Product not licensed in Canada, use is for croup in COVID-19 pandemic in place of nebulized epinephrine only at BCCH in the ED and PICU or by ITT under the advice of a physician at BCCH.

MDI to be used with a patient appropriated sized spacer device.

Monitoring:
Effectiveness - Westley Croup Score (LOC, cyanosis, stridor, air entry, retractions) before and after each set of inhalations.
Safety - continuous pulse oximetry and cardiorespiratory monitoring.

Adverse effects: tachycardia, increased BP, pallor, jitteriness.

NOTE:  This device requires activation (priming) by shaking and spraying 4 separate times and requires priming (shake and spray into the air 1 time) prior to each puff administered.  This is different than other MDI inhalers



Standard Prescription:

Epinephrine MDI __ puffs q10 mins PRN through spacer.

(Maximum: 15 puffs in 60 minutes)