Term
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Definition
1mg/1ml 1:1000 SC,IM,NEB
1mg/10ml 1:10000 IV and ET route only |
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Term
| Adrenaline Type of drug and main actions |
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Definition
Sympathomimetic -Alpha and beta agonist
-Naturally occuring and also manufactured. |
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Term
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Definition
| By monoamine oxidase and other enzymes in the blood, liver and around nerve endings. |
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Term
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Definition
Indications
•Cardiac arrest.
•Anaphylactic reactions.
•Asthma—life-threatening. |
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Term
Adrenaline
Adverse/Side effects |
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Definition
Adverse/Side effects
•Tachycardia.
•Arrhythmias, including ventricular fibrillation.
•Hypertension.
•Pupil dilation.
•Anxiety, tremor, nausea and vomiting. |
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Term
Adrenaline
Interactions
Precautions
Contraindications |
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Definition
Interactions-
As adrenaline is used for emergencies, possible interactions do not contraindicate its use, but awareness of possible effects is required.
•Other sympathomimetic agents, some antihistamines, tricyclic antidepressants—additive effect.
•Some beta blockers—beta effects blocked, alpha effects (vasoconstriction) increased, with increased risk of hypertension.
•Monoamine oxidase inhibitor (MAOI) antidepressants—increased effect of adrenaline because metabolism is inhibited.
Precautions-
These precautions apply only to patients not in cardiac arrest:
•Hypertension (uncontrolled or treated).
•Ischaemic heart disease.
Pregnancy Category A
Contraindications-
•When used with local anaesthetic, NEVER inject into extremities (remembered as rhyme: fingers, toes, nipples, nose, penis, clitoris, ear lobes). |
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Term
Adrenaline
Routes of administration |
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Definition
Routes of administration
•Subcutaneous.
•Intramuscular
•Intravenous
•Endotracheal
•Nebulised |
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Term
Adrenaline
Timing of drug effect |
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Definition
Timing of drug effect
•Intramuscular-
Onset:30–90 seconds
Peak:4–10 minutes
Duration:5–10 minutes
•Intravenous-
Onset:30 seconds
Peak:3–5 minutes
Duration:5–10 minutes |
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Term
Adrenaline
Dosage for cardiac |
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Definition
Cardiac arrest
–10 ml of 1:10 000 (1 mg) or 1 ml of 1:1000 (1 mg) (diluted to 10 ml with N/S and whole 10 ml administered). Given IV as a bolus in accordance with guideline on Adult Cardiorespiratory Arrest. Follow with a flush of 20–30 ml of normal saline.
–Repeat every 3 minutes while in arrest—there is no maximum dose.
–Via ETT: Give 2–3 mg (ARC states that 3–10 times the IV dose may be required). Dilute to 10 ml as necessary (with sterile water or normal saline), follow with a 20–30 ml flush of sterile water or normal saline to ensure the drug goes down the trachea rather than staying in the plastic of the ETT, and ventilate adequately (eg 5 breaths). |
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Term
Adrenaline
Dosage for Anaphylaxis |
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Definition
Anaphylaxis
–IM: 0.3–0.5 ml of 1:1000 (0.3–0.5 mg) (preferably into the deltoid muscle).
–Repeat every 5 minutes, as needed
–If patient in extremis (imminent cardiac or respiratory arrest): IV: I.0–2.0 ml of 1:10,000 (0.1–0.2 mg).
–Repeat every 1–2 minutes, titrating to response of circulation and breathing. |
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Term
Adrenaline
Dosage for asthma |
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Definition
Asthma (severe, unresponsive to salbutamol)
–0.3–0.5 ml of 1:1000 (0.3–0.5 mg) IM.
–Repeat every 5 minutes, as needed. |
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