Adrenaline Flashcards

1
Q

Presentation

A

1 mg in 1 ml glass ampoule (1:1,000)

1 mg in 10 ml glass ampoule (1:10,000)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pharmacology

A

Natural occurring alpha and beta-adrenergic stimulant

Beta 1

  • Increases HR by increasing SA node firing rate
  • Increases conduction velocity through AV node
  • Increases myocardial contractility
  • Increases irritability of ventricles

Beta 2
- Bronchodilatation

Alpha
- Peripheral vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Metabolism

A

By monoamine oxidase and other enzymes in the blood, liver and around nerve endings

Excreted by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indications

A
  • Cardiac arrest - VF/VT, Asystole or PEA
  • Inadequate perfusion (cardiogenic or non/cardiogenic/non-hypovolaemic)
  • Bradycardia with poor perfusion
  • Anaphylaxis
  • Severe asthma - imminent life threat not responding to nebulised therapy, or unconscious with no BP
  • Croup
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Contras

A

Hypovolaemic shock without adequate fluid replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Precautions

A

Consider reduced doses:

  • Elderly/frail
  • Cardiovascular disease
  • Monoamine oxidase inhibitors (depression/parkinsons)
  • Higher doses may be required for pt’s on beta blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Route of administration

A
  • IV
  • IM
  • Nebulised
  • IV infusion
  • IO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Side effects

A
  • Sinus tachycardia
  • Supraventricular arrhythmias
  • Ventricular arrhythmias
  • Hypertension
  • Pupillary dilatation
  • May increase size of MI
  • Feeling of anxiety/palpitations in the conscious pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Special notes

A

IV Adrenaline should be reserved for life threatening situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

IV effects

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

IM effects

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cardiac arrest

A

1 mg IV
repeat every 2nd cycle (4 minutely)
Flush with 20-30 mL saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Inadequate perfusion - cardiogenic (PE)

A

MICA - adrenaline infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Inadequate perfusion - non-cardiogenic/non-hypovolaemic (Sepsis)

A

MICA - adrenaline infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bradycardia

A

MICA - adrenaline infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anaphylaxis

A

Adult
500 mcg IM - repeat @ 5 mins until satisfactory results or side effects occur

<60kg/frail/elderly
300 mcg IM - repeat @ 5 mins until satisfactory results or side effects occur

Peadiatrics
10 mcg/kg IM - repeat @ 5 mins until satisfactory results or side effects occur

Upper airway obstruction - 5 mg Nebulised - repeat @ 5 mins until satisfactory results

Consider MICA for adrenaline infusion in all pt groups

17
Q

Severe asthma

A

Adults
500 mcg IM - repeat @ 5-10 mins, max 1.5 mg

Peadiatrics
10 mcg/kg IM - repeat @ 5-10 mins, max 30 mcg/kg IM

Consider MICA for adrenaline infusion in all pt groups

18
Q

Thunderstorm asthma

A

Consult clinician for:
20 mcg IV at 2 min intervals

Presentation for thunderstorm asthma
1 mg in 1 ml - dilute with 9 ml saline
= 1 mg in 10 ml (1000 mcg in 10 ml)

100 mcg in 1 ml - dilute (again) with 9ml saline
= 100 mcg in 10 ml

10 mcg in 1 ml

Consider MICA for adrenaline infusion

19
Q

Croup

A

5 mg Nebulised - repeat @ 5 mins until satisfactory results