Adrenaline Flashcards
What is the mechanism of action of adrenaline?
Alpha and beta adrenoceptor agonist
What are the beta1 effects of adrenaline?
Increases heart rate and contractility
What are the beta2 effects of adrenaline?
Causes peripheral vasodilatation
What are the alpha effects of adrenaline?
Causes vasoconstriction
What are the potential routes of delivery of adrenaline?
- IM
- IV
- Nebuliser (in croup)
What are the indications for the use of adrenaline?
- Anaphylaxis
- Cardiopulmonary resuscitation
- Bronchodilator in airway obstruction
- Local vasoconstriction
When might the local vasoconstriction effects of adrenaline be useful?
To stop bleeding during endoscopy, or mixed with local anaesthetic drugs
What are the contraindications to the use of adrenaline for anaphylaxis or CPR?
None
When should adrenaline be used with caution?
Patients with IHD or other cardiovascular conditions
What are the contraindications to the use of adrenaline with local anaesthetic?
Should not be used in organs with end-artery blood supply, e.g. nose, external ear, digits, genitalia
Why should local anaesthetic mixed with adrenaline not be used in organs with end-artery supply?
Risk of tissue necrosis
What is the dose of adrenaline for use in CPR?
1mg IV 1 in 10,000 every 3-5 minutes
What is the dose of adrenaline for use in anaphylaxis?
500 mcg IM 1 in 1000
What monitoring should be done with adrenaline?
Monitor vital signs during and after treatment
What might adrenaline interact with?
- Beta blockers
- MAOIs
What might happen if adrenaline is given with beta blockers?
Increased risk of hypertension
What might happen if adrenaline is given with MAOIs?
Increased risk of hypertensive crisis
What are the cardiovascular side effects of adrenaline?
- Angina
- MI
- Palpitations
- Tachycardia
- Arrhythmias
- Hypertension
- Cold extremities
- Pallor
What are the respiratory side effects of adrenaline?
- Dyspnoea
- Pulmonary oedema
What are the GI side effects of adrenaline?
- Nausea
- Anorexia
- Vomiting
- Hypersalivation
What are the genitourinary side effects of adrenaline?
- Urinary retention
- Difficulty in micturition
What are the CNS side effects of adrenaline?
- Anxiety
- Restlessness
- Insomnia
- Tremor
- Sweating
- Psychosis
What are the endocrine side effects of adrenaline?
- Hyperglycaemia
- Metabolic acidosis
- Hypokalaemia
What are the ophthalmic side effects of adrenaline?
- Angle-closure glaucoma
- Mydriasis
What patient counselling is required if a patient is given an adrenaline auto-injector?
- How to self administer
- Carry with them at all times
What counselling is required regarding how to administer an adrenaline auto-injector?
Demonstrate IM administration to patient and ensure that they know how to use the device by asking them to demonstrate. Provide written information to patient to take home after consultation
