Home Drug Guide Ephedrine Hydrochloride

Drug Guide

Generic Name

Ephedrine Hydrochloride

Brand Names Rezipres

Classification

Therapeutic: Decongestant, Bronchodilator, Vasopressor

Pharmacological: Sympathomimetic agent

FDA Approved Indications

Relief of bronchospasm associated with bronchial asthma, bronchitis, emphysema
Nasal decongestion
Hypotension (primarily in anesthesia)

Mechanism of Action

Ephedrine stimulates both alpha and beta-adrenergic receptors, leading to vasoconstriction and bronchodilation. It also increases norepinephrine release, which contributes to its sympathomimetic effects.

Dosage and Administration

Adult: Dose varies based on indication; typically 25-50 mg orally every 4-6 hours. IV doses for hypotension are 5-25 mg repeated as needed.

Pediatric: Dosing depends on age and weight; typically 0.2-0.5 mg/kg IV or IM, titrated to response.

Geriatric: Cautious use; start at lower doses due to increased sensitivity and comorbidities.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: No specific recommendations; use cautiously.

Pharmacokinetics

Absorption: Well-absorbed orally.

Distribution: Widely distributed throughout the body.

Metabolism: Metabolized minimally in the liver.

Excretion: Primarily excreted unchanged in urine.

Half Life: Approximately 3-6 hours.

Contraindications

hypersensitivity to ephedrine or other sympathomimetics
concurrent use of monoamine oxidase inhibitors (MAOIs)

Precautions

hypertension, cardiovascular disease, hyperthyroidism, diabetes, glaucoma, prostate hypertrophy

Adverse Reactions - Common

Insomnia (Common)
Restlessness (Common)
Nausea (Common)

Adverse Reactions - Serious

Hypertension or tachyarrhythmias (Serious)
Cardiac arrhythmias (Serious)
Stroke (Serious)

Drug-Drug Interactions

Monoamine oxidase inhibitors (risk of hypertensive crisis)
Beta-blockers (may reduce efficacy)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, cardiac rhythm, and neurological status.

Diagnoses:

Ineffective tissue perfusion related to vasoconstriction
Risk for hypertension

Implementation: Administer as prescribed, monitor vital signs closely, assess for adverse reactions.

Evaluation: Effectiveness of symptom relief, stability of vital signs, absence of adverse effects.

Patient/Family Teaching

Advise against use with other adrenergic or monoamine oxidase inhibitor medications.
Inform about potential side effects such as increased blood pressure, rapid heart rate, insomnia.
Advise to report chest pain, severe headache, or palpitations immediately.

Special Considerations

Black Box Warnings:

Potential for hypertensive crisis if combined with MAOIs.

Genetic Factors: Unknown.

Lab Test Interference: May affect certain blood pressure measurements.

Overdose Management

Signs/Symptoms: Severe hypertension, tachycardia, agitation, tremors, seizures.

Treatment: Administer antihypertensive agents such as alpha-blockers or vasodilators; supportive care; activated charcoal if ingestion recent; consider ICU care.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable when stored properly.