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What is the Presentation of Adrenaline?
1mg in 1ml Ampule (1:1000)
1mg in 10ml Ampule (1:10,000)
What is the Pharmacology of Adrenaline
A naturally occuring Alpha & Beta adrenergic stimulant
- * ↑HR by ↑SA node firing rate (β1)
- * ↑Conduction velocity through AV node (β1)
- * ↑Myocardial Contractility (β1)
- * ↑Irritability of the ventricles (β1)
- * Bronchodilatation (β2)
- * Peripheral vasoconstriction (α)
How is Adrenaline Metabolised?
By monamine amine oxidase and other enzymes in blood, live and around nerve endings
Excreted by the kidneys
What are the primary emergency indications for adrenaline?
- 1. VF or pulseless unconscious VT
- 2. Asystole
- 3. Electromechanical dissociation
- 4. Anaphylasis
- 5. Severe Asthma & Unconscious with no BP
- 6. Croup
- 1. Inadequate Perfusion - Cardiogenic
- 2. Inadequate Perfusion - Non Cardiogenic Non Hypovolaemic
- 3. Bradycardia with poor perfusion
When is Adrenaline contraindicated?
Hypovolaemic shock without adequate fluid replacement
What are the precations for using Adrenaline?
- 1. Elderly
- 2. Pts with cardiovascular disease
- 3. Pts on Monoamine oxidase (MAO) inhibitors
- 4. Pts on Beta blockers (higher doses may be required)
By what route can Adrenaline be administered?
- IV infusion
What are the side effects of Adrenaline?
- Sinus tachycardia
- Ventricular arrhythmias
- Pupillary dilatation
- May increase size of infarction
- Feeling of anxiety or palpitations in the conscious pt
Adrenaline special notes & times
IV adrenaline should be reserved for life threatening situations
- IV onset: 30sec
- IV peak: 3-5min
- IV duration: 5-10min
- IM onset: 30-90sec
- IM peak: 4-10min
- IM duration: 5-10min
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