Adrenaline ' Epinephrine " : Sympathomimetics

dr.joan

1. Adrenaline ' Epinephrine " : Sympathomimetics
Trade name: Adrenaline
Class: Direct acting-adrenergic agent.
Pregnancy: (Category C)
Action:
A natural hormone produced from adrenal medulla; induce marked stimulation of alpha, β1 + β2 receptors causing cardiac stimulation, bronchodilation & decongestion.
Uses:
1- Relief of respiratory distress due to bronchospasm.
2- Rapid relief of hypersensitivity reactions.
3- Cardiac arrest.
4- Open- angle glaucoma.
5- To prolong the action of anesthesia.
6- Topically to stop bleeding.
Dose:
Available in ampoules of 1ml containing 1 mg adrenaline
Can be given by I.M injection. I.V. & S.C.
In CPR "A systole and PEA":
1 in 10 000 (100 micrograms/mL) is recommended in a dose of 10 mL by intravenous injection, preferably through a central line.
If injected through a peripheral line, the drug must be flushed with at least 20 mL sodium chloride 0.9% injection (to aid entry into the central circulation).
In Acute anaphylaxis:
By intramuscular injection (preferably midpoint in anterolateral thigh) (or by subcutaneous injection " not generally recommended ' ) of 1 in 1000 (1 mg/mL) solution " when there is doubt as to the adequacy of the circulation, by slow intravenous injection of 1 in 10 000 (100 micrograms/mL) solution (extreme caution),
Dose:
IV: 10 micrograms/kg " 1 in 10 000 " as indicated: every 3-5 min"
If endotracheal route:
The used dose should be 3-10 times IV dose and diluted.
IM injection
Adult 0.5 mg may be repeated several times if necessary at 5- minute intervals according to blood pressure, pulse and respiratory function
Infusion: 2-10 mic/min titrated to response.
Contraindications:
§ Narrow angle glaucoma.
§ Shock
§ Lactation.
§ Tachycardia
§ During labor (it may delay the 2nd 8 loge do labor).
Side effects:
§ Fatal ventricular fibrillation.
§ Cerebral hemorrhage
§ urinary retention,
§ headache,
§ necroses at injection side,
§ Blurring of vision, photophobia.

Nursing considerations:

• Never administer 1: 100 solutions IV. Use 1: 1000 mg sol. For I.V. use.
• Use tuberculin (1cc) syringe to measure adrenaline.
• Administer adrenaline using piggyback set to adjust the rate of infusion.
• Administer infusion by electronic infusion device for safety & accuracy.
• Closely monitor patients receiving I.V. adrenaline infusion.
• Note the client for signs of shock “loss of consciousness, clammy, cold skin, cyanosis…. etc.).

Briskly massage site of S.C. or I.M. injection to hasten the action of the drug.

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