DTP Adrenaline

Question 0

Metabolism of adrenaline

Answer 0

Majority by sympathetic nerve endings.

Subject to mitochondrial enzymatic breakdown by monoamine oxidase at the synaptic level.

Question 1

Drug class for adrenaline

Answer 1

Sympathomimetic

Question 2

Pharmacology of adrenaline

Answer 2

Catecholamine acting on a and b adrenoreceptors.
Increases heart rate (b1), force of contraction (b1), irritability of the ventricles (b1).
Causes bronchodilation (b2) and peripheral vasoconstriction (a1).

Question 3

Indications for adrenaline

Answer 3

1. Anaphylaxis or severe allergic reaction
2. Severe life threatening bronchospasm or silent chest - pt must be able to speak in only single words AND / OR have haemodynamic compromise AnD / OR have an ALOC.
3. Cardiac arrest
4. Croup with stridor at rest
5. (ICP) Bradycardia with poor perfusion unresponsive to atropine and top
6. (ICP) Shock excluding hemorrhagic causes unresponsive to adequate fluid therapy

Question 4

Contraindications for adrenaline

Answer 4

KSAR

Question 5

Presentation of adrenaline

Answer 5

1mg in 1ml

1mg in 10mls

Question 6

Onset of adrenaline

Answer 6

IVI 30 secs

IMI 60 secs

Question 7

Side effects of adrenaline

Answer 7

1. Anxiety
2. Pupillary dilation
3. Tacharrythmias / palpatations
4. Hypertension

Question 8

Half-life of adrenaline

Answer 8

2 mins

Question 9

Duration of adrenaline

Answer 9

5-10 mins

Question 10

Schedules of adrenaline

Answer 10

1: 1000 s3
1: 10000 unscheduled

Question 11

Special notes of adrenaline

Answer 11

• Repeated Im doses in the same location may cause tissue necrosis and Ischaemia
• All cannulae must be flushed after admin

Question 12

What are the 1:1000 and 1:10 000 presentation used for?

Answer 12

1: 1000 adrenaline should be used for all nebuliser doses
1: 10000 adrenaline should be used for all low dose IV injections, e.g paediatric arrest

Question 13

Adult doses of adrenaline for Cardiac arrest

Answer 13

• 1mg IVI repeatable at 3-5 mins NMD

Question 15

Adult doses of adrenaline Anaphylaxis or Severe Allergic Reaction

Answer 15

• 300mcg IMI

@ 5 mins NMD

Question 16

Adult dose of Adrenaline for Isolated facial swelling or angioedema with no stridor at rest

Answer 16

5mg NEB

Single dose

Question 17

Adult doses of adrenaline for Severe life threatening bronchospasm OR Silent chest (Pts; speak in single words/haemodynamic compromise/ALOC)

Answer 17

• 300 mcg IMI

@ 5 min NMD

Question 17

Paed dose of Adrenaline for Isolated facial swelling or angioedema with no stridor at rest

Answer 17

5 mg NEB, single dose only.

Question 18

Paediatric doses of adrenaline for Anaphylaxis or severe allergic reaction.

Answer 18

> 6yo @ 300mcg

IMI @ 5 mins NMD

Question 20

Paediatric doses of adrenaline for Croup with stridor at rest

Answer 20

5 mg NEB

single dose only.

Question 20

Paediatric doses of adrenaline for Severe life threatening bronchospasm OR Silent chest (Pts; speak in single words/haemodynamic compromise/ALOC)

Answer 20

> 6yo @ 300mcg

IMI @ 5 mins NMD

Question 21

Paediatric doses of adrenaline for Cardiac arrest

Answer 21

> 10kg (>1yo) - 10mcg/kg

IV @ 3-5min NMD

Question 22

Preparation of adult IV adrenaline

Answer 22

Draw up 1mg/1ml (or 3) straight into a 3ml syringe

Question 23

Preparation of Paediatric IV adrenaline

Answer 23

Draw up 1mg/10ml in a 10ml syringe