Adrenaline

Question 1

Mechanism of action ?

Answer 1

A potent agonist of a1, a2, b1 &b2 receptors -> fight &flight effects : vasoconstriction of the vessels supplying : skin, mucosa &abdominal viscera (a1 mediated), increases heart rate, force of contraction &excitability(b1). And vasodilatation of vessels supplying the heart &muscles (b2).
Additional effects mediated by b2, bronchodilatation &suppression of inflammation mediated by the release from mast cells.
Alpha 2 receptors in the brain stem and in the periphery inhibit sympathetic activity and thus lower blood pressure. Alpha 2 receptor agonists such as clonidine or guanabenz reduce central and peripheral sympathetic overflow and via peripheral presynaptic receptors may reduce peripheral neurotransmitter release.

Question 2

Indication ?

Answer 2

• Cardiac arrest as a part of the Advanced Life Support ALS algorithm.
• Anaphylaxis; immediate management.
• It may be injected is some tissues to induce local vasoconstriction. Per ex, in endoscopy to reduce mucosal bleeding or mixed with anesthetic drugs to prolong anesthesia.

Question 3

Important AE ?

Answer 3

Anxiety, tremor, tachycardia &palpitations.
Particularly in patients with cardiovascular issues, it induces angina arrhythmia &myocardial infraction.

Angelina loves random policemen arrests : Adrenaline AE, specifically patients presenting cardiovascular issues.