Adrenaline

Question 1

What is adrenaline?

Answer 1

Adrenaline (1mg/1mL) is a naturally occurring catecholamine which primarily acts on Alpha & Beta adrenergic receptors.

The actions of these receptors include:

• Increased HR
• Increased force of cardiac contractions
• Increased irritability of the ventricles
• Bronchodilation
• Peripheral vasoconstriction

Metabolised by sympathetic nerve endings.

Onset: 30-60 sec
Duration: 5-10 min
Half-life: 2 min

Question 2

Indications for adrenaline?

Answer 2

1. Cardiac arrest
2. Anaphylaxis or severe allergic reaction
3. Severe life-threatening bronchospasm or silent chest (patients must only be able to speak in single words and/or have haemodynamic compromise or an ALCO
4. Croup (moderate to severe)

Question 3

Contraindications for adrenaline?

Answer 3

Nil

Question 4

Precautions for adrenaline?

Answer 4

1. Hypertension
2. Hypovolemic shock
3. Concurrent MAOI therapy
4. Quetiapine toxicity

Question 5

Side effects of adrenaline?

Answer 5

1. Anxiety
2. Hypertension
3. Palpitations/tachyarrhythmias
4. Pupil dilation
5. Tremor

Question 6

What is the adrenaline dose for an adult in cardiac arrest?

Answer 6

1mg IV

Repeated every 3-5 min
No max dose

Question 7

What is the adrenaline dose for a paediatric in cardiac arrest?

Answer 7

Newly born - 50 microg IV
<10kg (less than 1yr) - 100 microg IV
>10kg (1-12 yrs) - 10 microg/kg IV

Repeated every 3-5 min
No max dose

Question 8

What is the adrenaline dose for an adult with anaphylaxis or severe allergic reaction?

Answer 8

500 microg IM

Repeated at 5 min intervals
No max dose

If upper airway obstruction that is refractory to 3 x IM adrenaline injections:
5 mg NEB

Single dose only

Question 9

What is the adrenaline dose for a paediatric with anaphylaxis or severe allergic reaction?

Answer 9

<6 months - 50 microg IM
6 months - 1 year - 100 microg IM
1 - 6 yrs 150 microg IM
6 - 12 yrs 300 microg IM

Repeated at 5 min intervals
No max dose

If upper airway obstruction that is refractory to 3 x IM adrenaline injections:
5 mg NEB

Single dose only

Single dose only

Question 10

What is the adrenaline dose for an adult with severe life-threatening bronchospasm or silent chest?

Answer 10

500 microg IM

Repeated at 5 min intervals
No max dose

Question 11

What is the adrenaline dose for a paediatric with severe life-threatening bronchospasm or silent chest?

Answer 11

<6 months - 50 microg IM
6 months - 1 year - 100 microg IM
1 - 6 yrs 150 microg IM
6 - 12 yrs 300 microg IM

Repeated at 5 min intervals
No max dose