Adrenaline

Question 1

Presentations

Answer 1

1mg/1ml

1mg/10ml

Question 2

Indications

Answer 2

1. Cardiac arrest - VT, VF, PEA, Asytole
2. Inadequate perfusion (cardiogenic or non-cardiogenic/ non-hypovolaemic)
3. Bradycardio with poor perfusion
4. Croup
5. Severe asthma - imminent life threat/ not responding to Neb, unconscious with no BP

Question 3

Contraindication

Answer 3

Hypovolaemic shock without adequate fluid resuscitation

Question 4

Precautions

Answer 4

1. ? Decreased doses for
   - Elderly or frail
   - Pts on MOI
   - Pts with cardiovascular disease
2. ? Increased doses for pts on beta blockers

Question 5

Side effects

Answer 5

1. Sinus tachycardia
2. Ventricular arrhythmias
3. Supraventricular arrhythmias
4. HTN
5. Palpitations or anxiety
6. May increase size of MI
7. Pupil dilation

Question 6

Pharmacology

Answer 6

Adrenaline is an Alpha and Beta dare ethic agonist working on Alpha 1, Beta 1 and Beta 2 receptors.
Actions include:
1. Increases HR through increasing SA node - Beta 1
2. Increases conduction through AV node - Beta 1
3. Increases myocardial contractility - Beta 1
4. Increases ventricular irritability - Beta 1
5. Causes bronchodilation - Beta 2
6. Causes peripheral vasoconstriction - Alpha 1

Question 7

Metabolism

Answer 7

Metabolised by monoamine oxidase and other enzymes in liver

Question 8

Excretion

Answer 8

Excreted by the kidneys

Question 9

IV effects

Answer 9

Onset - 30secs
Peak - 3-5 mins
Duration - 5-10mins

Question 10

IM effects

Answer 10

Onset - 30-90secs
Peak - 4-10mins
Duration - 5-10 mins