Adrenaline
From Ganfyd
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Introduction
Adrenaline (aka epinephrine) is used in the treatment of anaphylaxis. It is the prototype catecholamine.
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Clinical Use
Indications
Administration
Parental
- IV only give slowly 1 in 10,000 dilution at no more than 100 micrograms per minute in adults
- IM see above
- S/C not recommended due to unpredictable absorption
Clinical Issues
People not understanding the difference between anaphlaxis doses and routes and those used in other indications they may see more of in their training
Contra-indications
Cautions and Interactions
- Hyperthyroidism
- Ischaemic heart disease
- Cerebrovascular disease
- Arrhythmias
- Hypertension
- Acute-angle glaucoma
- Second stage labour
- Could interact with patients completely betablocked causing severe hypertension
Side effects
- Hypertension
- Tachycardia and Arrhythmias
- Anxiety
- Tremor
- Nausea and vomiting
- Sweating
- Headache
- Dizziness
- Pulmonary oedema
- Weakness
Special advice
Pharmacology
The actions of catecholamines are far more complex than the classic actions on the cardiovascular system, with the different subtypes of receptor being expressed widely and having important neurotransmitter and metabolic actions. There is marked differential expression between individuals and the sexes causing significantly different cardiovascular and other responses. The classic alpha1 action of vasoconstriction and alpha2 restraint of sympathetic nervous outflows and inhibition of release of noradrenaline from sympathetic nerves are the tip of an iceberg where different polymorphisms are associated with say hypertension and insulin resistance and many aspects of CNS function.
It acts on the adrenergic receptors of which there are at least 10 subtypes.
