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.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.