Generic Name

Ephedrine Sulfate

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Classification

FDA Approved Indications

• Treatment of hypotension associated with anesthesia or shock

Mechanism of Action

Ephedrine stimulates alpha- and beta-adrenergic receptors, leading to vasoconstriction and increased cardiac output, thereby elevating blood pressure.

Dosage and Administration

Adult: Typically 5-25 mg IV every 4-6 hours as needed; dosage varies based on clinical response.

Pediatric: Dosing based on weight, usually 0.1-0.2 mg/kg IV; titrate to response.

Geriatric: Start at lower doses; monitor cardiovascular function closely.

Renal Impairment: Adjust doses cautiously; no specific guidelines, monitor closely.

Hepatic Impairment: No specific dosing adjustments established; use with caution.

Pharmacokinetics

Absorption: Poor oral absorption; administered parenterally.

Distribution: Widely distributed; crosses the placenta.

Metabolism: Partially metabolized in the liver.

Excretion: Excreted primarily in the urine; unchanged and as metabolites.

Half Life: Approximately 3-6 hours.

Contraindications

• Hypertension
• Cardiovascular disease, including coronary artery disease
• Hypersensitivity to ephedrine

Precautions

• Use with caution in patients with hyperthyroidism, diabetes, glaucoma, or prostate hypertrophy.
• Monitor cardiovascular status during administration.

Adverse Reactions - Common

• Elevated blood pressure (Common)
• Tachycardia (Common)
• Insomnia, Anxiety (Common)

Adverse Reactions - Serious

• Arrhythmias (Less common)
• Hypertension crisis (Rare)
• Cerebral hemorrhage (Rare)

Drug-Drug Interactions

• Other sympathomimetics, MAO inhibitors, tricyclic antidepressants (increase risk of hypertensive episodes)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report chest pain, dizziness, or palpitations immediately.
• Do not use without healthcare provider’s guidance.

Special Considerations

Black Box Warnings:

• Use with caution due to potential severe hypertension and cardiovascular events.

Genetic Factors: No specific genetic markers identified.

Lab Test Interference: May interfere with tests measuring catecholamines or urinary metabolites.

Overdose Management

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

Treatment: Discontinue drug immediately, provide supportive care, administer antihypertensives if necessary, and manage seizures if they occur.

Storage and Handling

Storage: Store at controlled room temperature, protected from light.

Stability: Stable under recommended storage conditions.