Adrenaline

Question 1

Indications for Adrenaline

Answer 1

• Anaphylaxis (IM)
• Severe asthma (IM)
• Stridor causing moderate or severe respiratory distress (Nebulised)
• IN for clinically significant epistaxis. or not controlled after 15mins
• Topical for clinically significant bleeding from a wound.

Question 2

Contraindications for Adrenaline

Answer 2

None

Question 3

Cautions for Adrenaline

Answer 3

• Myocardila Ischaemia
• Tachydysrythmia

Question 4

Actions of adrenaline

Answer 4

• Acts on Alpha 1 and Beta 1/2 receptors.
• Alpha 1 causes smooth muscle contraction/ vasoconstriction of blood vessels. And stimulation of glycogenolysis and gluconeogenesis
• Beta 1 causes an increase in cardiac contractility/ HR and speed of electrical conduction.
• Beta 2 causes smooth muscle relaxation/ vasodilation/ bronchodilation and stabilisation of mast cell reducing histamine release

Question 5

Adrenaline Dosage

Answer 5

• IM = 0.5mg, repeat after 10 mins or 5min for anaphylaxis if PT is deteriorating.
• IN = x1 amp adrenalin (1mg/1ml) With 0.9 sodium chloride. Give 2ml per nostril Can repeat after 20mins
• Neb = x5 1ml amps (5ml)
• Topical = 1 amp (1mg/1ml) per 9ml sodium chloride

Question 6

Adrenaline side effects/ onset time

Answer 6

• side effects = Tachy, anxious, tremor, nauseous
• onset = IM: 2-5 minutes.
  Nebulised, IN and topical: contact with the target site.