# Epinephrine not taking effect
**URL:** https://discourse.kitware.com/t/epinephrine-not-taking-effect/906
**Category:** Pulse Physiology Engine
**Created:** [October 4, 2022, 3:14pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906 "2022-10-04T15:14:14Z")
**Posts on this page:** 7
**Page:** 1
### Author:  [@amanu7777](https://discourse.kitware.com/u/amanu7777)
#### Post date: [October 4, 2022, 3:14pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906/1 "2022-10-04T15:14:14Z")
I was interested in your pulse physiology system for developing an anaphylaxis simulation and saw that one of your showcase scenarios covers this. I attempted to recreate the scenario with a standard patient but for some reason, the epinephrine dose was not taking effect. I used the exact dosage, concentration, and administration route that is done in the showcase scenario but there seems to be nothing happening when I administer the epinephrine. Could you please get back to me on how I can get this to work or if I am missing something?
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### Author:  [@abray](https://discourse.kitware.com/u/abray)
#### Post date: [October 4, 2022, 3:39pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906/2 "2022-10-04T15:39:47Z")
[This scenario demonstrates the use of epi](https://gitlab.kitware.com/physiology/engine/-/blob/4.x/data/human/adult/scenarios/drug/Epinephrine.json)
You can see the epi getting into the system
It shows an increase of heart rate and respiration rate.
Which scenario are you refering to?
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### Author:  [@amanu7777](https://discourse.kitware.com/u/amanu7777)
#### Post date: [October 4, 2022, 3:43pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906/3 "2022-10-04T15:43:40Z")
I used standard male and gave an airway obstruction of 0.75 and let the O2 levels get down to about 80. I administered epinephrine as follows :
"Substance: Epinephrine
Administration Route: Intravenous
Administration Duration: No Administration Duration Set
Dose: 0.3(mL)
Concentration: 1(g/L)
TotalInfusedDose: NaN”.
This did not take any affect on the O2 levels.
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### Author:  [@amanu7777](https://discourse.kitware.com/u/amanu7777)
#### Post date: [October 4, 2022, 3:46pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906/4 "2022-10-04T15:46:25Z")
I used standard male and gave an airway obstruction of 0.75 and let the O2 levels get down to about 80. I administered epinephrine as follows :
"Substance: Epinephrine
Administration Route: Intravenous
Administration Duration: No Administration Duration Set
Dose: 0.3(mL)
Concentration: 1(g/L)
TotalInfusedDose: NaN”.
This did not take any effect on the O2 levels.
below is the scenario log :
[127.58(s)] Serializing from file ./states/DefaultMale@0s.json
[127.58(s)] Human Adult Whole Body
[127.58(s)] Version : 4.1.0
[127.58(s)] GitHash : 04f2597c
[127.58(s)] Build Time : Tue Oct 4 11:48:10 2022
[11.04(s)] [Action] 11.04(s), Patient Action : Airway Obstruction
Severity: 0.75
[24.64(s)] [Event] 24.64(s), Patient has Bradypnea
[59.26(s)] [Event] 59.26(s), Patient has Hypoxia
[67.14(s)] [Event] 67.14(s), Patient has Tachycardia
[89.04(s)] [Action] 89.04(s), Patient Action : Substance Bolus
Substance: Epinephrine
Administration Route: Intravenous
Administration Duration: No Administration Duration Set
Dose: 0.3(mL)
Concentration: 1(g/L)
TotalInfusedDose: NaN
[89.04(s)] Defaulting bolus administration duration of Epinephrine to 2s
[89.06(s)] Starting Baroreceptor timer
[89.06(s)] Baroreceptors Saturated
[89.56(s)] Stopping Baroreceptor timer
[90.28(s)] Starting Baroreceptor timer
[92.84(s)] Stopping Baroreceptor timer
[108.04(s)] [Event] 108.04(s), Engine has entered state : RespiratoryAcidosis
[203.52(s)] [Event] 203.52(s), The patient is in a state of moderate hypocapnia
[205.86(s)] [Event] 205.86(s), Patient’s Respiratory Driver has exceeded the maximum target pulmonary ventilation rate, setting value to the maximum allowable rate
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### Author:  [@abray](https://discourse.kitware.com/u/abray)
#### Post date: [October 4, 2022, 3:48pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906/5 "2022-10-04T15:48:52Z")
We don’t really have a anaphilaxis model.
Based on the Plasma Concentration of Epi, you need to manually reduce the airway obstruction
[You can see how we did this here](https://gitlab.kitware.com/physiology/explorer/-/blob/722656443df77e8ee8374ecf97f00f3e329db911/showcases/AnaphylaxisShowcaseWidget.cxx#L113)
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### Author:  [@amanu7777](https://discourse.kitware.com/u/amanu7777)
#### Post date: [October 4, 2022, 3:56pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906/6 "2022-10-04T15:56:20Z")
I see, so if I am understanding this correctly in the showcase patient the “give epinephrine” uses the actual dose to increase heart rate and respiration rate and also triggers the airway obstruction to be set to 0 to fix the Oxygen levels ?
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### Author:  [@abray](https://discourse.kitware.com/u/abray)
#### Post date: [October 4, 2022, 4:16pm UTC](https://discourse.kitware.com/t/epinephrine-not-taking-effect/906/7 "2022-10-04T16:16:34Z")
Right, the drug model will increase the HR and RR, but it not going to affect the airway obstruction, so you need to do that manually. You are creating your own model using the actions proveded by Pulse.