Ephedrine use as a supplement 2020 Johannesburg, South Africa., Johannesburg

Ephedrine increases arterial blood pressure and has a positive inotropic effect. Because it does not have detrimental effects on uterine blood flow in animal models, ephedrine became widely used as a pressor in hypotensive pregnant patients. However, phenylephrine is now the preferred treatment for hypotension in the parturient because of a decreased risk of fetal acidosis (also seeChapter 33). As a result of its β1-adrenergic stimulating effects, ephedrine is helpful in treating moderate hypotension, particularly if accompanied by bradycardia. The usual dose is 2.5 to 10 mg given intravenously or 25 to 50 mg administered intramuscularly.

Tachyphylaxis to the indirect effects of ephedrine may develop as norepinephrine stores are depleted. In addition, although drugs with indirect activity are widely used as a first-line therapy for intraoperative hypotension, repeat doses of ephedrine administration in life-threatening events (instead of switching to epinephrine) may contribute to morbidity.4