Initial dose in the case of a cardiac arrest should be 1mg (that is 10mL of 1:10,000) intravenously.
This should be injected more slowly in elderly patients as they are more susceptible to the effects of adrenaline.
The preferred route is via a central venous catheter.
This dose (1mg) can be administered 3-5 minutely throughout cardiopulmonary resuscitation (CPR).
Children should receive 0.1mL/kg (0.01mg/kg) repeated 5 minutely as required.
To maintian blood pressure after the return of a spontaneous pulse, bolus doses or continuous infusions may be useful.
Action of Adrenaline Hydrochloride Injection:
Adrenaline stimulates certain chemical receptors in the body resulting in constriction of blood vessels, increased blood pressure, fast pulse, widening of the space inside the windpipe, higher blood sugar levels, lower blood potassium levels and antihistamine effects (eg. Stops the overproduction of mucous). It is useful in cardiac arrests because it stimulates the heart. Adrenaline acts rapidly and for a very short time, so often more than one dose is necessary.
Dose advice of Adrenaline Hydrochloride Injection:
If you are using a Min-I-Jet prefilled syringe, discard unused adrenaline immediately after use.
Adrenaline is considered safe to use during pregnancy, however its use is not recommended in the second stage of labour or if the blood pressure is greater than 130/80mmHg during pregnancy. NOTE: adrenaline is excreted in breast milk.
Adrenaline HCl is a banned substance in sports. Adrenaline HCl is relatively contraindicated in patients with:
Hyperthyroidism (over-active thyroid);
Hypertension (high blood pressure);
Ischaemic heart disease (history of angina or heart attack);
Cardiac dilatation (larger than normal heart chambers, often due to valve disease);
Arrhythmia (an abnormal heart rhythm);
Cerebral arteriosclerosis (Thickened, stiff blood vessel walls in the blood vessels that supply the brain. This may result in headache, dizziness and blurred vision);
Pregnancy with a blood pressure greater than 130/80mmHg;
Non-anaphylactic shock;
Organic brain damage;
General anaesthetic with halogenated hydrocarbons or cyclopropane;
Injuries at sites perfused only by end-arteries. Adrenaline HCl should be used with caution in patients with:
Lung and heart disease;
Cardiac arrhythmias, such as VF, prefibrillatory rhythm, tachycardia (abnormal heart rhythms).
Myocardial infarction (heart attack);
Diabetes Mellitus (high blood sugars);
Asthma and emphysema, especially if combined with heart disease;
Narrow-angle glaucoma (high pressures in the eyes);
Phenothiazine-induced shock (Phenothizine is used to treat hyperactivity, anxiety, mania and schizophrenia);
A repeated injury at one particular site;
Prostatic hypertrophy (enlarged prostate);
Psychoneuronsis;
Parkinsonian syndromes;
Intra-arterial injuries (damage to the inside of blood vessels);
IM injections into the buttocks;
Second stage labour (adrenaline may delay delivery. It prevents uterine contractions); and
Elderly patients.
Do NOT inject adrenaline into digits (fingers or toes), ears, nose or genitals.
Do NOT inject adrenaline into arteries. Significant vasoconstriction and gangrene may result.
Sulfite-containing preparations may cause an allergic reaction.
Schedule of Adrenaline Hydrochloride Injection:
1 mg/10 mL (1:10,000): Unscheduled; 1 mg/mL (1:1,000):
Schedule 3
Common side effects of Adrenaline Hydrochloride Injection:
Anxiety;
Restlessness;
Fast pulse;
Tremor;
Weakness;
Dizziness;
Headache;
Shortness of breath;
Cold hands and feet;
Pale skin colour;
Sweating;
Nausea and vomiting;
Insomnia; and
Flushing (redness in the skin, particularly in the face).
Uncommon side effects of Adrenaline Hydrochloride Injection:
Hallucinations;
Disorientation; and
Changes in memory, mood and personality.
Diseases treated by Adrenaline Hydrochloride Injection:
Treatments associated with Adrenaline Hydrochloride Injection:
For further information talk to your doctor.
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