Adrenaline

Question 1

Adrenaline
Type

Answer 1

A naturally occurring catecholamine

Question 2

Adrenaline
Presentations

Answer 2

1:10,000 - 1mg in 10ml glass ampoule
1:1,000 - 1mg in 1ml glass ampoule

Question 3

Adrenaline
Actions

Answer 3

1. Alpha effect: peripheral vasoconstriction
2. Beta 1 effects:
   a) increased rate of sinus node
   b) increased myocardial contractility
   c) increased AV conduction
   d) increased myocardial irritability
3. Beta 2 effects:
   a) bronchodilation
   b) vasodilation of skeletal muscle
   Onset: IV - 30 secs; IM 30-90 secs
   Max effect: IV 3-5mins; IM 4-10mins

Question 4

Adrenaline
Uses

Answer 4

1. Cardiac arrest
   - VF and VT - no output
   - asystole
   - PEA
2. Anaphylaxis
3. Severe life-threatening asthma
4. Severe upper airway obstruction due to swelling

ICP uses
- Bradyarrhythmias resistant to atropine
- Shock unresponsive to fluid boluses

Question 5

Adrenaline
Adverse Effects

Answer 5

1. Tachycardia
2. Tacharythmias
3. Hypertension

Question 6

Adrenaline
Contraindications

Answer 6

Known hypersensitivity

Question 7

Adrenaline
Precautions

Answer 7

These apply to patients with cardiac output only:
1. care with patients with history of hypertension
2. care with patients with history of ischaemic heart disease
3. Give extremely slowly to patients on MAO inhibitor antidepressants (e.g. Nardil, Parnate) as adrenaline may provoke a greatly exaggerated response. Generally, patients on MAOIs with cardiac output should receive no more than 1/4 of the normal dose of adrenaline, titrated to response.

Question 8

Adrenaline
Cardiac Arrest Dose

Answer 8

Adult: 1mg IV or IO - fast push (no limit on doses in cardiac arrest)

Paediatric: 0.01mg/kg - fast push (no limit on doses in cardiac arrest)

Question 9

Adrenaline
Anaphylaxis/Severe Life-threatening asthma Dose

Answer 9

Adult: IM: 0.5mg - repeat 5 minutely (max 3 doses)

Paediatric: IM: 0.01mg/kg (up to 50kg) - repeat 5 minutely (max 3 doses)
ICP for IV/IO infusion

Question 10

Adrenaline
Severe upper airway swelling Dose

Answer 10

Adult: IM: 0.5mg - repeat 5 minutely (max 3 doses)

Paediatric: Weight >10kg - neb 5ml adrenaline 1:1,000
Weight <10kg - nebulise 0.5ml/kg adrenaline 1:1,000 (make volume up to 5ml with saline, as required)
Single dose only