Adrenaline Flashcards
Presentation
1 mg in 1 ml glass ampoule (1:1,000)
1 mg in 10 ml glass ampoule (1:10,000)
Pharmacology
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
Metabolism
By monoamine oxidase and other enzymes in the blood, liver and around nerve endings
Excreted by the kidneys
Indications
- 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
Contras
Hypovolaemic shock without adequate fluid replacement
Precautions
Consider reduced doses:
- Elderly/frail
- Cardiovascular disease
- Monoamine oxidase inhibitors (depression/parkinsons)
- Higher doses may be required for pt’s on beta blockers
Route of administration
- IV
- IM
- Nebulised
- IV infusion
- IO
Side effects
- Sinus tachycardia
- Supraventricular arrhythmias
- Ventricular arrhythmias
- Hypertension
- Pupillary dilatation
- May increase size of MI
- Feeling of anxiety/palpitations in the conscious pt
Special notes
IV Adrenaline should be reserved for life threatening situations
IV effects
Onset: 30 secs
Peak: 3-5 mins
Duration: 5-10 mins
IM effects
Onset: 30-90 secs
Peak: 4-10 mins
Duration: 5-10 mins
Cardiac arrest
1 mg IV
repeat every 2nd cycle (4 minutely)
Flush with 20-30 mL saline
Inadequate perfusion - cardiogenic (PE)
MICA - adrenaline infusion
Inadequate perfusion - non-cardiogenic/non-hypovolaemic (Sepsis)
MICA - adrenaline infusion
Bradycardia
MICA - adrenaline infusion