Adrenaline

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.

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.

CV diseases; hyperthyroidism; DM; Parkinson's disease; elderly; pregnancy, lactation. Lactation: Unknown if excreted into breast milk; use caution.

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.

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.

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)

Cardiac arrest, Anaphylaxis, Superficial bleeding, Acute asthma

Angina,Anxiety,Apprehensiveness,Cardiac arrhythmias,Dizziness,Dyspnea,Flushing,Headache,Hypertension,Nausea,Nervousness,Pallor,Palpitations,Respiratory difficulties,Restlessness,Sweating,Tachycardia,Tremor,Vasoconstriction,Vomiting,Weakness

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.