Description
Latin name
Adrenaline
Packing
5 ampoules of 1 ml.
Pharmacological action
Adrenaline is an alpha and beta adrenostimulant. At the cellular level, the effect is due to the activation of adenylate cyclase on the inner surface of the cell membrane, an increase in the level of intracellular cAMP and the entry of Ca2 + into the cell.
Increases heart rate and heart rate, shock and minute output, increases conductivity, myocardial excitability and automatism. Increases myocardial oxygen demand. It narrows the vessels of the organs of the abdominal cavity, skin, mucous membranes, and, to a lesser extent, skeletal muscles. Increases blood pressure (mainly systolic), in high doses increases OPSS.
Pressor effect can cause short-term reflex slowdown of heart rate. Relaxes the smooth muscles of the bronchi.
Lowers the tone and motility of the digestive tract. Expands the pupils, helps to reduce the production of intraocular fluid and intraocular pressure. Causes hyperglycemia and increases plasma free fatty acids.
Indications
Allergic reactions of the immediate type (including anaphylactic shock) developing with the use of drugs, sera and other medicinal allergens, bronchial asthma (relieving an attack)
Hypoglycemia (due to an overdose of insulin), hypokalemia
Asystole, cardiac arrest, bleeding (stopping), lengthening of local anesthetics
AV block III (acute development)
Open angle glaucoma.
Contraindications
Hypersensitivity, arterial hypertension, angina pectoris, severe atherosclerosis, cardiac asthma, aneurysm, diabetes mellitus, thyrotoxicosis, pregnancy, angle-closure glaucoma
State of general anesthesia (caused by fluorotan, cyclopropane, chloroform – due to the risk of arrhythmias).
Special instructions
For infusion, use a device with a measuring device to control the infusion rate. Infusions should be carried out in a large (preferably central) vein. It is administered intracardially with asystole, if other methods are not available, because there is a risk of cardiac tamponade and pneumothorax.
During treatment, it is recommended to determine the concentration of K + in blood serum, the measurement of blood pressure, urine output, IOC, ECG, central venous pressure, pulmonary artery pressure and jamming pressure in the pulmonary capillaries. Excessive doses for myocardial infarction can enhance ischemia by increasing myocardial oxygen demand.
Increases glycemia, which is why diabetes requires higher doses of insulin and sulfonylurea derivatives. With endotracheal administration, absorption and final plasma concentration of the drug may be unpredictable.
The administration of epinephrine in cases of shock does not replace transfusion of blood, plasma, blood-replacing fluids and / or saline solutions. Epinephrine is not advisable to use for a long time (narrowing of peripheral vessels, leading to the possible development of necrosis or gangrene).
There are no well-controlled studies in the use of epinephrine in pregnant women. A statistically regular relationship was found between the occurrence of deformities and inguinal hernia in children whose mothers used epinephrine during the first trimester or throughout pregnancy, and one case of fetal anoxia after iv administration of the mother of epinephrine was also reported.
Epinephrine should not be used in pregnant women with blood pressure above 130/80 mm Hg. Animal experiments have shown that when administered in doses 25 times higher than the recommended dose for humans, it causes a teratogenic effect. When used during breastfeeding, the risk and benefit should be assessed due to the high likelihood of side effects in the child.
The use for the correction of hypotension during childbirth is not recommended, since it can delay the second stage of childbirth when administered in large doses to weaken uterine contractions and may cause prolonged uterine atony with bleeding.
Can be used in children with cardiac arrest, but caution should be exercised because 2 different concentrations of epinephrine are required in the dosing schedule. Upon termination of treatment, the dose should be reduced gradually, because sudden withdrawal of therapy can lead to severe hypotension.
Easily destroyed by alkalis and oxidizing agents.
If the solution becomes pinkish or brown or contains a precipitate, it must not be administered. Unused part should be destroyed.
Composition of
1 ml of solution contains:
Active ingredient:
adrenaline hydrochloride 1 mg.
Dosage and administration
Parenteral:
In case of anaphylactic shock and other allergic reactions, hypoglycemia – sc, less often – in / m or in / in slowly
Adults – 0.2-0.75 ml, children – by 0, 1 0.5 ml
Highest doses for adults with sc administration: single – 1 ml, daily – 5 ml.
In an attack of bronchial asthma in adults – s / c of 0.3-0.7 ml.
When cardiac arrest – intracardially 1 ml.
Topically: to stop bleeding – tampons moistened with a solution of the drug in a solution of local anesthetics add a few drops immediately before administration.
Side effects
Tachycardia, arrhythmias (eliminated by beta-blockers), ventricular fibrillation, angina pectoris, increased blood pressure, pulmonary edema, anxiety, dizziness, headache, tremor, nausea, increased muscle stiffness and tremor in patients (tremor).
Drug Interactions
Epinephrine antagonists are alpha and beta adrenoreceptor blockers.
Reduces the effectiveness of diuretics, insulin, antipsychotics, M- and H-cholinostimulants, muscle relaxants.
Efficiency increases when combined with M-anticholinergics, MAO inhibitors, ganglion blockers, uterine tone stimulants, thyroid drugs, rauwolfia alkaloids.
Enhances the effect of aminophylline and thyroid drugs.
Overdose
Symptoms: excessive BP, tachycardia, bradycardia, rhythm disturbances (in. including atrial and ventricular fibrillation), cold and paleness of the skin, vomiting, headache, metabolic acidosis, myocardial infarction, cranial cerebral hemorrhage (especially in elderly patients), pulmonary edema, death.
Treatment: discontinue administration, symptomatic therapy – to reduce blood pressure – alpha-blockers (phentolamine), with arrhythmia – beta-blockers (propranolol).
Storage Conditions
In a cool, 12-15 ° C, light-proof location. Keep out of reach of children.
shelf life
3 years
Deystvuyushtee substance
pinefrin
drugstore terms
drugstore
Dosage form
injection for injection
Moscow endocrine factory, Russia
