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DCPM > Adrenaline > Flashcards

Adrenaline Flashcards

1
Q

Drug Class of Adrenaline

A

Sympathomimetic

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2
Q

Schedule of Adrenaline 1:1000

A

Schedule 3 (Therapeutic Poison)

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3
Q

Schedule of Adrenaline 1:10 000

A

Unscheduled

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4
Q

Pharmacology of Adrenaline

A

Adrenaline is a naturally occurring catecholamine which primarily acts 
 on Alpha (α) and Beta (β) adrenergic receptors. The actions of these receptors cause an increase in heart rate (β1), increase in the force of myocardial contraction (β1), increase in the irritability of the ventricles (β1), bronchodilation (β2) and peripheral vasoconstriction (α1).

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5
Q

Metabolism of Adrenaline

A

The majority of circulating adrenaline is metabolised by sympathetic nerve endings. It is subject to the process of mitochondrial enzymatic breakdown by monoamine oxidase at the synaptic level.

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6
Q

Indications of Adrenaline

A

• Anaphylaxis OR severe allergic reaction
• Severe life-threatening bronchospasm 

OR silent chest (patients must only be able to speak 
 in single words AND/OR have haemodynamic compromise AND/OR an ALOC)
• Bradycardia with poor perfusion 
 (unresponsive to atropine AND/OR TCP)
• Cardiac arrest
• Croup (with stridor at rest)
• Shock unresponsive to adequate fluid resuscitation (excluding haemorrhagic cause)

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7
Q

Contraindications for Adrenaline

A

• Nil

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8
Q

Precautions for Adrenaline

A
  • Hypertension
  • Hypovolaemic shock
  • Concurrent MAOI therapy
  • Multiple sclerosis
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9
Q

Side Effects of Adrenaline

A
  • Anxiety
  • Hypertension
  • Palpitations/tachyarrhythmias
  • Pupil dilation
  • Tremor
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10
Q

Presentation of Adrenaline

A
  • Ampoule, 1 mg/1 mL (1:1,000) adrenaline

* Ampoule, 1 mg/10 mL (1:10,000) adrenaline

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11
Q

Onset of Adrenaline IV

A

30 seconds (IV)

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12
Q

Onset of Adrenaline IM

A

60 Seconds (IM)

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13
Q

Duration of Adrenaline

A

5–10 minutes

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14
Q

Half Life of Adrenaline

A

2 minutes

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15
Q

Routes of Administration for Adrenaline

A 
Nebuliser (NEB)
Intramuscular injection (IM)
Intravenous injection (IV)
Intraosseous injection (IO)
Intravenous infusion (IV INF)
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16
Q

Special Notes of Adrenaline

A

• 1 : 1,000 (1 mg/mL) adrenaline presentation should be 
 used for all nebuliser administration.
• 1:10,000 (100 mcg/1 mL ) or a 1 : 100,000 (10 mcg/1 mL ) adrenaline preparation should be used for all low dose 
 IV injections (e.g. paediatric cardiac arrest). Ensure all syringes are appropriately labelled.
• If possible, all time critical adrenaline IM injections 
 should be via administered in the vastus lateralis (improved absorption).
• Repeated IM injections to the same site may cause ischaemia and/or necrosis.
• Suitably qualified officers should, where possible, administer adrenaline infusions through an appropriately placed CVL.
• Suitably qualified officers should, where possible, 
 utilise invasive pressure monitoring for patients being administered adrenaline infusions.
• Adrenaline infusions must be administered through 
 a dedicated line.
• All cannulae and IV lines must be flushed thoroughly 
 with sodium chloride 0.9% following each medication administration.


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17
Q 
Adult Dose (Adrenaline) (IM)
Anaphylaxis OR severe allergic reaction
A

300 mcg

Repeated at 5 minute intervals. 
 No maximum dose.

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18
Q 
Adult Dose (Adrenaline) (Neb)
Anaphylaxis OR severe allergic reaction
A

5 mg
Single dose only.
May be administered for facial or tongue 

swelling thought to be allergic in origin. If stridor present, IM or IV adrenaline must be administered.

19
Q 
Adult Dose (Adrenaline) (IV)
Anaphylaxis OR severe allergic reaction
A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

20
Q 
Adult Dose (Adrenaline) (IO)
Anaphylaxis OR severe allergic reaction
A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

21
Q 
Adult Dose (Adrenaline) (IM)
Severe life-threatening bronchospasm OR silent chest 
 (patients must only be able to speak in single words AND/OR have haemodynamic compromise AND/OR an ALOC)
A

300 mcg

Repeated at 5 minute intervals. 
 No maximum dose.

22
Q 
Adult Dose (Adrenaline) (IV)
Severe life-threatening bronchospasm OR silent chest 
 (patients must only be able to speak in single words AND/OR have haemodynamic compromise AND/OR an ALOC)
A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

23
Q 
Adult Dose (Adrenaline) (IO)
Severe life-threatening bronchospasm OR silent chest 
 (patients must only be able to speak in single words AND/OR have haemodynamic compromise AND/OR an ALOC)
A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

24
Q 
Adult Dose (Adrenaline) (IV)
Bradycardia with poor perfusion (unresponsive to atropine AND/OR TCP)
A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

25
Q 
Adult Dose (Adrenaline) (IO)
Bradycardia with poor perfusion (unresponsive to atropine AND/OR TCP)
A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

26
Q 
Adult Dose (Adrenaline) (IV)
Cardiac arrest
A

1 mg
Repeated at 3 – 5 minute intervals.
No maximum dose.

27
Q 
Adult Dose (Adrenaline) (IO)
Cardiac arrest
A

1 mg
Repeated at 3 – 5 minute intervals.
No maximum dose.

28
Q

Adult Dose (Adrenaline) (IV)
Shock unresponsive to adequate fluid resuscitation
(excluding haemorrhagic cause)

A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

29
Q

Adult Dose (Adrenaline) (IO)
Shock unresponsive to adequate fluid resuscitation
(excluding haemorrhagic cause)

A

20 – 50 mcg

Repeated at 1 minute intervals. 
 No maximum dose.

30
Q 
Paediatric Dose (Adrenaline) IM ≥ 6 years
Anaphylaxis OR severe allergic reaction
A

300 mcg


Repeated at 5 minute intervals. No maximum dose.

31
Q 
Paediatric Dose (Adrenaline) IM < 6 years
Anaphylaxis OR severe allergic reaction
A

150 mcg


Repeated at 5 minute intervals. No maximum dose.

32
Q 
Paediatric Dose (Adrenaline) Neb
Anaphylaxis OR severe allergic reaction
A

5 mg
Single dose only.
May be administered for facial or tongue 

swelling thought to be allergic in origin. If stridor present, IM or IV adrenaline must be administered.

33
Q 
Paediatric Dose (Adrenaline) IV
Anaphylaxis OR severe allergic reaction
A

2 mcg/kg
Single dose not to exceed 50 mcg.

Repeated at 2 minute intervals. No maximum dose.

34
Q 
Paediatric Dose (Adrenaline) IO
Anaphylaxis OR severe allergic reaction
A

2 mcg/kg
Single dose not to exceed 50 mcg.

Repeated at 2 minute intervals. No maximum dose.

35
Q 
Paediatric Dose (Adrenaline) IM ≥ 6 years
Severe life-threatening bronchospasm OR silent chest 
 (patients must only be able to speak in single words AND/OR 
 have haemodynamic compromise AND/OR an ALOC)
A

300 mcg


Repeated at 5 minute intervals. No maximum dose.

36
Q

Paediatric Dose (Adrenaline) IM

A

150 mcg


Repeated at 5 minute intervals. No maximum dose.

37
Q 
Paediatric Dose (Adrenaline) IV
Severe life-threatening bronchospasm OR silent chest 
 (patients must only be able to speak in single words AND/OR 
 have haemodynamic compromise AND/OR an ALOC)
A

2 mcg/kg
Single dose not to exceed 50 mcg.

Repeated at 2 minute intervals. No maximum dose.

38
Q 
Paediatric Dose (Adrenaline) IO
Severe life-threatening bronchospasm OR silent chest 
 (patients must only be able to speak in single words AND/OR 
 have haemodynamic compromise AND/OR an ALOC)
A

2 mcg/kg
Single dose not to exceed 50 mcg.

Repeated at 2 minute intervals. No maximum dose.

39
Q 
Paediatric Dose (Adrenaline) IV ≥ 10 kg (  ≥ 1 year )
Cardiac Arrest
A

10 mcg/kg

Repeated at 3 – 5 minute intervals. 

No maximum dose.

40
Q 
Paediatric Dose (Adrenaline) IV < 10 kg (< 1 year )
Cardiac Arrest
A

100 mcg

Repeated at 3 – 5 minute intervals. 

No maximum dose.

41
Q 
Paediatric Dose (Adrenaline) Neb
Croup
A

5 mg


Single dose only.

42
Q

Paediatric Dose (Adrenaline) IV
Shock unresponsive to adequate fluid resuscitation
(excluding haemorrhagic cause)

A

2 mcg/kg
Single dose not to exceed 50 mcg.

Repeated at 2 minute intervals. No maximum dose.

43
Q

Paediatric Dose (Adrenaline) IO
Shock unresponsive to adequate fluid resuscitation
(excluding haemorrhagic cause)

A

2 mcg/kg
Single dose not to exceed 50 mcg.

Repeated at 2 minute intervals. No maximum dose.

44
Q 
Paediatric Dose (Adrenaline) IV
Bradycardia with poor perfusion 
 (unresponsive to atropine AND/OR TCP)
A

QAS Clinical Consultation and Advice Line approval required in all situations.

DCPM (9 decks)

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