Adrenaline
Form: Injection
Strength: 1mg/ml
Generic Name: Adrenaline (Epinephrine)
Company: EDCL
MRP:৳ 25.0 (Injection)
Is Antibiotic: No
Indications
Adrenaline is used as a helper treatment for cardiac arrest. Adrenaline is used during cardiopulmonary resuscitation. If external heart compressions and attempts to restore circulation using defibrillation or pacemakers fail, an intracardiac puncture and injection of adrenaline might help. Adrenaline increases blood pressure, heart rate, air intake, blood glucose, stimulates the heart, and reduces allergic reactions caused by histamine. Adrenaline is used to treat allergic and anaphylactic reactions. Adrenaline is the preferred treatment for anaphylactic shock and should be given immediately if a person shows severe allergic symptoms. Adrenaline is also used in life-threatening asthma when breathing support and nebulizer treatments fail.
Pharmacology
Adrenaline works like the stimulation of adrenergic nerves, acting on both alpha and beta receptor sites of sympathetic cells. Its main actions are on the beta receptors of the heart, blood vessels, and other smooth muscles. When injected quickly into a vein, Adrenaline causes a quick increase in blood pressure, mainly systolic, by (1) stimulating the heart, making Adrenaline contract stronger, (2) increasing heart rate, and (3) narrowing blood vessels in areas like the skin, mucosa, and internal organs.
When injected slowly, Adrenaline usually causes only a moderate rise in systolic pressure and a fall in diastolic pressure, without a big rise in mean blood pressure. This means the body’s reflex responses to the increased pressure don’t stop its direct effect on the heart as much as with other drugs that mainly work on alpha receptors.
Dosage & Administration
Cardiac arrest:
Intravenous injection: 1 mg, repeated every 2-3 minutes if needed.
Endotracheal: 2-3 mg via an endotracheal tube, repeated as needed.
Intracardiac: 0.1 to 1 mg, injected directly into the heart.
Intraspinal: 0.2 to 0.4 mg mixed with anesthetic fluid to prolong the anesthetic effect.
Anaphylaxis, asthma, or severe bronchospasm:
Adult dose: 0.25 to 0.5 mg, repeated every 5 minutes until breathing and blood flow improve.
For dose dilution: Mix 1 mg of adrenaline with 9 ml Normal Saline.
Children: Start with 10 mcg/kg body weight, not exceeding 250 mcg. Can be repeated every 3-5 minutes if needed. Subsequent doses: 100 mcg/kg.
Interaction
Excessive doses of digitalis, mercurial diuretics, or other heart-sensitive drugs are not recommended with adrenaline. The effects of adrenaline can be stronger when used with tricyclic antidepressants, certain antihistamines (like Diphenhydramine, Tripelennamine, Chlorpheniramine), and L-thyroxine Sodium.
Contraindications
Adrenaline should not be used in people with high blood pressure, artery disease, coronary heart disease, or hyperthyroidism. Adrenaline should not be given to people taking monoamine oxidase inhibitors.
Side Effects
Common side effects include anxiety, restlessness, dizziness, headache, fast heart rate, shaking, weakness, and coldness in the hands and feet. These effects may happen even with small doses, especially when given with local anesthetics.
Pregnancy & Lactation
Adrenaline is a Pregnancy Category C drug. Adrenaline passes through the placenta and into breast milk. Adrenaline should only be used during pregnancy if the benefits outweigh the risks to the baby. Adrenaline is not recommended during breastfeeding because Adrenaline could affect the infant.
Precautions & Warnings
The solution should not be used if Adrenaline is pinkish or darker than light yellow or if Adrenaline contains particles. Adrenaline is easily destroyed by alkaline substances and oxidizing agents like oxygen, chlorine, iodine, and some metals, especially iron. Adrenaline should not be mixed with sodium bicarbonate. Administer Adrenaline slowly and carefully to elderly patients or those with heart disease, high blood pressure, diabetes, thyroid issues, or mental disorders. Use with caution in patients with long-term asthma and emphysema who have heart disease. Adrenaline may cause chest pain if there’s not enough blood flow to the heart.
Overdose Effects
Overdose may lead to heart arrhythmias, severe high blood pressure, fluid in the lungs, and brain hemorrhage. Medications like Labetalol (a combined alpha and beta blocker) or beta blockers can counteract adrenaline’s effects. Other medications, such as nitrates, may also help. Emergency medical support is essential for overdose cases.
Therapeutic Class
Adrenaline is classified under anaphylaxis, mydriatic and cycloplegic agents, other adrenergic stimulants, and respiratory stimulants (analeptics).
Storage Conditions
Store below 25°C, away from light, and keep out of reach of children.
Similar Brands of Adrenaline (Epinephrine) (Injection – 1mg/ml)
| Brand Name | Form | Strength | Company | MRP (৳) |
|---|---|---|---|---|
| Adrinor Injection | Injection | 1mg/ml | Incepta Pharmaceuticals Ltd. | 25.0 |
| Adrin | Injection | 1mg/ml | Gaco Pharmaceuticals(G.A Company Ltd) | 30.0 |