Presentation
- 1 mg in 1 mL glass ampoule (1:1,000)
- 1 mg in 10 mL glass ampoule (1:10,000)
Pharmacology
A naturally occurring alpha and beta-adrenergic stimulant
Actions:
- Increases HR by increasing SA node firing rate (Beta 1)
- Increases conduction velocity through the A-V node (Beta 1)
- Increases myocardial contractility (Beta 1)
- Increases the irritability of the ventricles (Beta 1)
- Causes bronchodilatation (Beta 2)
- Causes peripheral vasoconstriction (Alpha)
Metabolism
By monoamine oxidase and other enzymes in the blood, liver and around nerve endings; excreted by the kidneys
- Cardiac arrest – VF/VT, Asystole or PEA
- Inadequate perfusion (cardiogenic or non-cardiogenic/non-hypovolaemic)
- Bradycardia with poor perfusion
- Anaphylaxis
- Severe asthma – imminent life threat not responding to nebulised therapy, or unconscious with no BP
- Croup
- Hypovolaemic shock without adequate fluid replacement
Consider reduced doses for:
- Elderly / frail patients
- Patients with cardiovascular disease
- Patients on monoamine oxidase inhibitors
- Higher doses may be required for patients on beta blockers
Route of administration
- IV
- IM
- Nebulised
- IV infusion
- IO
- Sinus tachycardia
- Supraventricular arrhythmias
- Ventricular arrhythmias
- Hypertension
- Pupillary dilatation
- May increase size of MI
- Feeling of anxiety/palpitations in the conscious patient
Special Notes
IV Adrenaline should be reserved for life threatening situations.
IV Effects
Onset: 30 seconds
Peak: 3 – 5 minutes
Duration: 5 – 10 minutes
IM Effects
Onset: 30 – 90 seconds
Peak: 4 – 10 minutes
Duration: 5 – 10 minutes