Pharmacology

Adrenaline

presentation, onset, duration, peak

1mg in 1ml

IM onset: 30-90 seconds

Peak: 3-5 mins

Duration: 5-10 minutes

Adrenaline

pharmacology

Alpha and beta-adrenergic stimulant.

Beta 1 affects (4):

Increases HR by SA node firing

Increases conduction velocity through the AV node

Increases myocardial contractility

Increases ventricular irritability

Beta 2: increases bronchodilation

Alpha: causes peripheral vasoconstriction

Adrenaline

Indications and contraindications

• Cardiac arrest

• Shock

• Anaphylaxis

• Croup

• Severe asthma (not responding to nebs or unconscious with no BP)

• Bradycardia with poor perfusion

• hypovolaemic shock without adequate fluid replacement

Adrenaline

Precautions and side effects

Precautions- consider reduced dose for:

• elderly/frail

• cardiovascular disease

• pts on monoamine oxidase inhibitors

larger dose for pts on beta blockers.

(Elder hearts MAOI-dly beat bigger)

Side effects:

• sinus tachycardia

• Hypertension

• Anxiety/palpitations

• Rhythms (supraventricular rhythms, Ventricular arrhythmias)

• Pupillary dilation

• May increase the size of MI

(SHARP MI)