Home Adrenaline

Adrenaline

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

  1. Cardiac arrest – VF/VT, Asystole or PEA
  2. Inadequate perfusion (cardiogenic or non-cardiogenic/non-hypovolaemic)
  3. Bradycardia with poor perfusion
  4. Anaphylaxis
  5. Severe asthma – imminent life threat not responding to nebulised therapy, or unconscious with no BP
  6. Croup
  1. Hypovolaemic shock without adequate fluid replacement
Consider reduced doses for:
  1. Elderly / frail patients
  2. Patients with cardiovascular disease
  3. Patients on monoamine oxidase inhibitors
  4. 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

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