Adrenaline Injection
Adrenaline (Epinephrine)
1.8 mg
Hindusthan Pharmaceuticals Ltd.
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Indications
Adrenaline Injection is used for:
Cardiac arrest, Anaphylaxis, Superficial bleeding, Acute asthma
Adult Dose
Parenteral
Acute asthma
Adult: 0.3-0.5 ml (300-500 mcg). Dose may be given via IM or SC inj.
Intravenous
Advanced cardiac life support (Cardiac Arrest)
Adult:
1. Intravenous injection: 1 mg injection repeated every 2-3 minutes as necessary.
2. Endotracheal: 2-3 mg via an endotracheal tube, repeated as necessary.
3. Intracardiac injection: 0.1 to 1 mg, direct into the atrium of the heart.
4. Intraspinal use: Usual dose is 0.2 to 0.4 mg added to anesthetic spinal fluid mixture (to prolong anesthetic action by limiting absorption).
Anaphylactic shock
Adult: 0.5 mg (5 mL) given at a slow rate of 100 mcg/minute, stopping when a response is achieved.
Intramuscular
Anaphylactic shock
Adult: 500 mcg (0.5 ml), repeat every 5 minutes as needed until improvement occurs. For emergency self-admin (e.g. via autoinjector): A dose of 300 mcg (0.3 ml) may be used.
Child Dose
Parenteral
Acute asthma
Child: 0.01 ml/kg (10 mcg/kg). Max: 0.5 ml (500 mcg). Dose may be given via IM or SC inj.
Intravenous
Advanced cardiac life support (Cardiac Arrest)
Child: Initially, 10 mcg/kg, may repeat as often as every 2-3 minutes throughout the resuscitation process. Endotracheal doses: 100 mcg/kg. Intraosseous doses are the same as IV doses.
Max Dosage: Intraosseous doses for adults and children are the same as IV doses.
Anaphylactic shock
Child: 10 mcg/kg. If auto injectors are used, doses are based on body wt: 15-30 kg: 150 mcg and >30 kg: 300 mcg.
Intramuscular
Anaphylactic shock
Child: Dose depends on age and weight. Usual dose: 10 mcg/kg.
Renal Dose
Administration
IV Administration
Central line; infusion pump required
IV Preparation
Solution: 1 mg in 250 mL D5W or NS (4 mcg/mL) to make up concentration of 15-60 mL/hr (1-4 mcg/min)
Contra Indications
Preexisting hypertension; occlusive vascular disease; angle-closure glaucoma (eye drops); hypersensitivity; cardiac arrhythmias or tachycardia. When used in addition to local anaesthetics: Procedures involving digits, ears, nose, penis or scrotum.
Precautions
CV diseases; hyperthyroidism; DM; Parkinson's disease; elderly; pregnancy, lactation.
Lactation: Unknown if excreted into breast milk; use caution.
Pregnancy-Lactation
Interactions
Halogenated inhalation anaesthetics; alpha- or beta-blocking agents; methyldopa, guanethidine; drugs with vasoconstrictor and pressor effects; antihypertensives; adrenergic neuron blockers; potassium-depleting drugs; cardiac glycosides; ephedra, yohimbe. TCAs may induce hypertension and arrhythmia.
Adverse Effects
Side effects of Adrenaline (Epinephrine) :
Angina,Anxiety,Apprehensiveness,Cardiac arrhythmias,Dizziness,Dyspnea,Flushing,Headache,Hypertension,Nausea,Nervousness,Pallor,Palpitations,Respiratory difficulties,Restlessness,Sweating,Tachycardia,Tremor,Vasoconstriction,Vomiting,Weakness
Mechanism of Action
Epinephrine, an active principle of the adrenal medulla, is a direct-acting sympathomimetic. It stimulates alpha- and beta-adrenergic receptors resulting in relaxation of smooth muscle of the bronchial tree, cardiac stimulation and dilation of skeletal muscle vasculature. It is frequently added to local anaesthetics to retard diffusion and limit absorption, to prolong the duration of effect and to lessen the danger of toxicity.
Note
Adrenaline 1.8 mg Injection manufactured by Hindusthan Pharmaceuticals Ltd.. Its generic name is Adrenaline (Epinephrine). Adrenaline is availble in Nepal.
Farmaco Nepal drug index information on Adrenaline Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.