CPP Adrenaline

Question 1

Adrenaline

Presentations

Answer 1

a) 1mg adrenaline glass vile
(1ml of 1:1000 = 1mg/ml),
b) 1mg adrenaline glass vile
(10ml 1:10,000 = 100mcg),
c) EpiPen (300mcg) recommended for adults and children aged >5YO,
d) EpiPen Jr (150mcg) recommended for children 7.5 to 20kg (aged around
1 to 5yrs).

Question 2

Adrenaline

Primary Emergency Indications

Answer 2

a) Cardiac arrest - VF, VT, Asystole or PEA,
b) Cardiogenic shock,
c) Anaphylaxis,
d) Critical asthma,
e) Stridor due to inflammation.

Question 3

Adrenaline

Contraindications
(Known hypersensitivity plus)

Answer 3

a) Contraindications are relative as this product is intended for use in life threatening emergencies,
b) Hypovolaemic shock without adequate fluid replacement.

Question 4

Adrenaline

Precautions

Answer 4

Consider reduced doses for:
- Elderly/Frail pts,
- Pts w cardiovascular disease,
- Pts on monoamine oxidase inhibitors.

• Higher doses may be required for pts on beta blockers.

Question 5

Adrenaline

Key timings (IM route)

Answer 5

Onset - 30-90sec,
Peak - 4-10min,
Duration - 5-10min.

Question 6

Adrenaline

Special notes and important interactions

Answer 6

a) All pts receiving adrenaline for possible anaphylaxis are to be tx to hospital,
b) Ideal site for IM is mid-outer thigh,
c) IM adrenaline has short duration - monitor pt closely for reoccurrence of symptoms,
d) Pts taking alpha blockers at increased risk of hypotension and tachycardia,
e) Pts taking non selective beta blockers may experience severe HTN and bradycardia.

Question 7

Adrenaline

Side effects

Answer 7

a) Tachycardia,
b) Arrhythmias,
c) HTN,
d) Dilated pupils,
e) Anxiety or palpitations,
f) May increase size of MI.

Question 8

Adrenaline

Pharmacology or actions

Answer 8

Naturally occurring alpha and beta adrenergic stimulant.

a) Increases HR by increasing SA node firing rate,
b) Increases myocardial contractility,
c) Increases the irritability of the ventricles,
d) Causes bronchodilation,
e) Causes peripheral vasoconstriction.