Adrenaline

Question 1

Presentation

Answer 1

1mg in 1ml glass ampoule (1:1,000)

Question 2

Pharmacology

Answer 2

A naturally occurring alpha and beta adrenergic stimulant
Beta 1
- increases the irritability of the ventricles
- increases myocardial contractility
- increase HR by increasing SA node firing rate
- increases conduction velocity through AV node
Beta 2
- bronchodilation
Alpha
- peripheral vasoconstriction

Question 3

Metabolism

Answer 3

By Monoamine oxidase and other enzymes in the blood, liver and around nerve endings; excreted by the kidneys

Question 4

Indications

Answer 4

Cardiac arrest - VF/VT, asystole or PEA
Anaphylaxis
Severe asthma - imminent life threat not responding to nebuliser therapy, or unconscious with no BP
Croup

Question 5

Contraindications

Answer 5

Hypovolaemic shock without adequate fluid replacement

Question 6

Precautions

Answer 6

Consider reduced doses for:
Elderly/frail patients
Patients with cardiovascular disease
Patients on MAO inhibitors

Higher does may be required for patients on beta blockers

Question 7

Route of admin

Answer 7

IV
IM
Nebulised

Question 8

Side effects

Answer 8

Sinus tachycardia 
Supraventricular arrhythmias
Ventricular arrhythmias
Hypertension
Pupillary dilation
May increase size of MI
Feeling of anxiety/palpitations in the conscious patient

Question 9

Special notes

Answer 9

IV
Onset: 30 seconds
Peak: 3-5 minutes
Duration: 5-10 minutes
IM 
Onset: 30-90 seconds
Peak: 4-10 minutes
Duration: 5-10 minutes