In addition to hypotension, epinephrine use can cause vasospasm in which tissues?

• A. Liver and spleen
• B. Bone marrow
• C. Ears, Nose, Fingers, Toes, Clitoris, and Penis
• D. Lungs

Answer: (C)

Epinephrine's alpha-adrenergic effects cause vasoconstriction, and this is most evident in tissues with end-arterial blood supply. The ears, nose, fingers, toes, and external genitalia (clitoris and penis) rely on small, tightly perfused vessels with limited collateral circulation, so alpha-1–mediated vasoconstriction can produce significant vasospasm there. This can lead to ischemia if blood flow is markedly reduced.

Other tissues listed don’t typically experience this same pattern of vasospasm from epinephrine. The liver and spleen have rich collateral circulation and different regulatory patterns; the lungs mainly respond with bronchodilation and changes in pulmonary vascular resistance rather than focal vasospasm of end-arteries.