adrenaline

Question 1

Indications

Answer 1

• Cardiac arrest.
• Anaphylaxis.
• Severe asthma.
• Imminent respiratory arrest from COPD.
• Severe bradycardia.
• Blood pressure support if unresponsive to metaraminol.
• A Septic shock, cardiogenic shock and neurogenic shock unresponsive to 0.9% sodium chloride and metaraminol IV.
• Stridor causing moderate or severe respiratory distress
• IN for clinical significant epistaxis

-Topical for wounds

Question 2

Contraindications and cautions

Answer 2

Contraindications:
- None.

Cautions:
- Myocardial ischaemia. Adrenaline will increase myocardial oxygen consumption.

• Tachydysrhythmias. Adrenaline will usually make tachydysrhythmias worse.

Question 3

Action

Answer 3

Adrenaline stimulates alpha and
beta adrenergic receptors, with the predominant effects occurring at alpha 1, beta 1, and beta 2 receptors:

• Alpha 1 stimulation causes
  smooth muscle contraction,
  vasoconstriction of blood vessels, and stimulation of glycogenolysis and gluconeogenesis.
• Beta 1 stimulation causes an
  increase in inotropy (cardiac
  contractility), an increase in
  chronotropy (heart rate), and an increase in dromotropy (speed of electrical conduction within
  the heart).
• Beta 2 stimulation causes smooth muscle relaxation,
  skeletal muscle vasodilation, bronchodilation, and
  stabilisation of mast cell membranes, membranes,
  reducing histamine release

Question 4

Dosage

Answer 4

Adults:
CA - 1mg
Topical/IN: 1:10000
Neb: 5mg
IM: 0.5mg
Infusion: 1:100000 fluids/ 2 drop a sec or 3mg diluted to 50ml then 0.5mg/hr

Paeds see CPGs

Question 4

Route

Answer 4

• IV
• IO
• IM
• Topical
• IN

Question 4

Side effects

Answer 4

• Tachycardia
  – Tachydysrhythmia
  – Myocardial ischaemia
  – Ventricular ectopy
  – Hypertension
  – Nausea and vomiting
  – Tremor, anxiety and sweating
  – Hyperglycaemia.