Adrenaline

Introduction

Adrenaline (also known as epinephrine) is a hormone and a neurotransmitter, and is used to treat several medical conditions such as allergies, anaphylaxis, cardiac arrest, and other acute medical emergencies. It is available as a vasopressor, antihypertensive, and antiarrhythmic agent, and works by inducing vasoconstriction, increasing blood pressure, and stimulating the heart.

Uses for Adrenaline

Adrenaline is used to treat a variety of medical conditions, including asthma and allergy attacks, anaphylaxis, cardiac arrest, ventricular arrhythmias, and hypotension. It is also used to treat hypoglycemia, bronchospasm, and pulmonary edema.

Brand Name	Adrenaline
Type
Weight
Generic	Adrenaline
Manufacturer
Available in	English বাংলা

Mechanism of Action

Adrenaline works by binding to α- and β-adrenergic receptors in the body, which trigger a variety of physiological effects. Its primary actions include increasing cardiac output, increasing heart rate, increasing blood pressure, and increasing airway resistance. It also relaxes bronchial smooth muscle, increases renal blood flow, and increases the breakdown of glycogen.

How Long Does it Take to Work?

Adrenaline usually works within minutes. The effects can last up to an hour, depending on the dose and the medical condition being treated.

Absorption

Adrenaline is rapidly and completely absorbed when injected into a muscle, and its effects can be felt within minutes.

Route of Elimination

Adrenaline is metabolized primarily in the liver. It is also metabolized in the kidneys and lungs. Its route of elimination is primarily by the kidneys, with up to 70% of a single dose being eliminated in the urine.

Dosage

Cardiac arrest:

• Intravenous injection: 1 mg injection repeated every 2-3 minutes as necessary.
• Endotracheal: 2-3 mg via an endotracheal tube, repeated as necessary.
• Intracardiac: 0.1 to 1 mg, direct into the atrium of the heart.
• Intraspinal: Usual dose is 0.2 to 0.4 mg added to anesthetic spinal fluid mixture (to prolong anesthetic action by limiting absorption).

Anaphylaxis, asthma or severe bronchospasm:

• Adult dose is 0.25 0.5 mg. It may be repeated at 5 minutes intervals until perfusion and respiratory status normalizes.
• In case of dose dilution: 1 mg of Adrenaline to be diluted in 9 ml Normal Saline.

Children: Initially 10 mcg/kg body weight, not to exceed 250 mcg. May be repeated every 3-5 minutes if necessary. Subsequent doses should be 100 mcg/kg. The dose of adrenaline will depend on the medical condition it is being used to treat, as well as the patient's age and weight. Common doses range from 0.01 mg/kg to 0.3 mg/kg body weight, depending on the condition being treated.

Administration

Adrenaline can be administered by intravenous, intramuscular, or subcutaneous injection. It can also be administered as a continuous infusion or as an aerosol inhalation.

Side Effects

Common side effects of adrenaline include anxiety, restlessness, palpitations, headache, nausea, vomiting, weakness, sweating, tremor, and a rapid, irregular pulse. It can also cause arrhythmias, hypertension, and bronchospasm.

Toxicity

Adrenaline is generally safe and well tolerated, but may cause toxicity in higher doses or with prolonged use. Signs and symptoms of toxicity include severe arrhythmias, hypertension, myocardial infarction, stroke, and death.

Precautions

Adrenaline should be used with caution in patients with cardiovascular disease or those taking other medications, as it can increase blood pressure and heart rate. In addition, it should not be given to patients with known hypersensitivity to the drug or its components.

Interactions

Adrenaline may interact with other medications, including beta-blockers, calcium-channel blockers, and monoamine oxidase inhibitors.

Disease Interactions

Adrenaline may interact with certain diseases, including thyroid disease, diabetes, and liver or kidney disease.

Drug Interactions

Adrenaline can interact with certain drugs, including beta-blockers, calcium-channel blockers, and monoamine oxidase inhibitors.

Food Interactions

Adrenaline may interact with certain foods, including grapefruit juice, coffee, and alcohol.

Pregnancy Use

It is not recommended to use adrenaline during pregnancy, as it can cause uterine contractions, decreased fetal blood pressure, and fetal distress.

Lactation Use

Adrenaline is not recommended during breastfeeding, as it may be excreted in breast milk and can have adverse effects on the infant.

Acute Overdose

Signs and symptoms of an acute overdose of adrenaline include restlessness, trembling, palpitations, tachycardia, nausea, chest pain, hypotension, bradycardia, disorientation, anxiety, seizures, and coma.

Contraindications

Adrenaline is contraindicated in patients with known hypersensitivity to the drug or its components, and should also not be used in patients with pheochromocytoma, thyrotoxicosis, and tachyarrhythmias.

Use Direction

Adrenaline should be used as directed by a healthcare professional. The dose will depend on the medical condition being treated, as well as the patient's age and weight. It should not be used for longer than recommended by a healthcare professional.

Storage Condition

Adrenaline should be stored at room temperature and away from direct light and moisture. It should also be kept away from children and pets.

Volume of Distribution

Adrenaline has a volume of distribution of 10-20 L/kg.

Half Life

The half-life of adrenaline is approximately 3-5 minutes.

Clearance

Adrenaline has an elimination clearance of approximately 110 mL/min per kg.

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