Adrenaline
Also known as: Epinephrine
Adrenaline is a sympathomimetic amine, alpha-and beta-adrenoreceptor agonist, synthesized from tyrosine in the adrenal medulla and released along with small quantities of nor-it into blood stream, upon stimulation by the central nervous system in response to stress, anger or fear, acting to increase heart rate, blood pressure, cardiac output and carbohydrate metabolism. Adrenaline is a very potent vasoconstrictor and cardiac stimualnt. It also acts as a bronchodialator (dilates the bronchi i.e. air passage) and relieves respiratory discomfort in bronchial asthma and emphysema.
Primary Characteristics
Adrenaline is also known as Epinephrine.
It is of Natural origin and belongs to Catecholamine.
It belongs to Alpha & Beta adrenergic agonist pharmacological group on the basis of mechanism of action and also classified in Syumpathomimetic pharmacological group. It is also classified under Drugs used in Shock .
Molecular Weight: 183.2 · pKa: 8.7, 10.2, 12 · Solubility in Water: > 1 in 100 · Solubility in Alcohol: < 1 in 10000 · Non-proprietary name: Adrenaline · pH: 4.5 · Isotonic value: 4.24.
Pharmacokinetics
Absorption: Adrenaline has an oral bioavailability is 75% (±5%), pre-systemic (first-pass) metabolism accounts for 75% (±5%).
Distribution: Adrenaline has a plasma protein binding is 50%.
Elimination: it is metabolised via 99% via liver, plasma half-life is 3-10 min, renal excretion is 70-95%.
Advertisement
Indications
Adrenaline is primarily indicated in conditions like Acute allergic reactions, Anaphylactic shock, Angioedema, Capillary bleeding in palliative care, Cardiac arrest, Life-threatening angioedema, Metastatic colorectal cancer, Open-angle glaucoma.
Adrenaline is also indicated for secondary conditions like Anesthesia, Cardiopulmonary resuscitation, Priapism.
Contraindications
Adrenaline is contraindicated in conditions like Diabetes mellitus, Hypertension, Hyperthyroidism, Ischaemic heart disease, Angle-closure glaucoma.
Dosage
Adrenaline's dosage details are as follows:
| Dose | Single Dose | Frequency | Route | Instructions |
|---|---|---|---|---|
| Adult Dosage | ||||
| 0.5 – 2 % | — | — | Eye Drops | use in 5-10 mintues after administration of a mitotic eye drop For open angle Glaucoma |
| 500 mcg | 500 mcg | — | IM | Adrenaline should be given every 5 minutes For Anaphylaxis, Bronchospam and allergy. |
| 200 – 500 mcg | — | — | SC | Every 20-25 minutes |
| 11 ug/min | 11 ug/min | — | Slow-IV | or 1 mg for 2-3 minutes upto 1 hour for Cardiac Arrest |
| 11 ug/min | 11 ug/min | — | Solution | 1:1,000 Solution. for bleeding forocal anesthesia : minimum : 1:80,000 , maximum 1:200000 |
| 2 – 3 mg | — | — | Via ETT | Every 15-30 Minutes, As Required |
| Paediatric Dosage (20kg) | ||||
| 100 – 0 mcg/kg | — | — | ETT | dose may increase upto 100mcg/kg for advance cardiace life support |
| 120 – 250 mcg/kg | — | — | Intra Muscular | Single Dose |
| 10 – 0 mcg/kg | — | — | IV | dose may increase upto 100mcg/kg for advance cardiace life support |
| Neonatal Dosage (3kg) | ||||
| 0.006 – 0.012 mg/kg | — | — | Intramuscular | Single dose |
Drug Interactions
Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Side Effects
Adrenaline in overdosage may give rise to further complications which include Local ischemic necrosis.
Adrenaline produces potentially life-threatening effects which include Ventricular fibrillation, Cerebral hemorrhage, Pulmonary edema . Careful monitoring is needed with proper medical management.
The signs and symptoms that are produced after acute overdosage of Adrenaline are Cerebral hemorrhage, Pulmonary edema , Cardiac arrhythmias, Rise in B.P. .
Adrenaline is known to cause more or less tolerable side effects which are usually transient. These include Anxiety, Cold extremities, Dizziness, Dyspnea, Headache, Palpitation, Redness of eye, Restlessness, Stinging, Tachycardia, Tremors, Weakness.
Warnings / Precautions
Available Brands
Click on a strength to view available brands.
Single Ingredient
Multi-Ingredient Combinations
Storage Conditions
Drug Classification
- 1.1.2 — Local anesthetics
- 2.3 — Anti-allergics (Antihistamines) and drugs used in anaphylaxis
- 3.12.2 — Antiarrhythmic drugs