Other Names

Adrenalin

Classification

Sympathomimetic

Action

1. •Beta-1 and 2 effects
   

2. •Alpha effects at higher dosages
   

3. •Inhibits histamine release
   

Indications

1. •Treatment of VF, asystole (may also be used for symptomatic bradycardia although not first line agent)
   

2. •Treatment of very severe allergic conditions
   

3. •Treatment of status asthmaticus
   

4. •Treatment of severe croup
   

Contraindications

1. •Uncorrected tachyarrhythmias
   

2. • Marked hypertension
   

Precautions

1. •Caution in patients with cerebral arteriosclerosis, hypertension, shock (hypotension)
   

2. •Patients > 35 years of age
   

Adverse Reactions

1. •Palpitation
   

2. •Respiratory difficulty
   

3. •Restlessness, feelings of panic
   

4. •Hypertension
   

Interactions/Compatibility/Stability

1. •Protect vials from light
   

2. •Do not use solution if brown in color or contains precipitate
   

3. •Compatible in D5W, NS, Ringer’s Lactate
   

4. •Do not administer in same line as alkaline solutions)
   

Special Considerations

1. •Massage of SC injection site hastens absorption (IM route may be considered due to poor peripheral perfusion)
   

2. •Can be given by endotracheal tube by doubling the IV route dose for adults
   

3. •Use infusion devices for all infusions
   

Dosages

Preparations:

1. •1 mg 1:10,000 (10 ml preload) IV/IO/ETT
   

2. •1 mg 1:1,000 (1 ml ampule) IV/IO/SC/Nebulized
   

Adult:

1. •Cardiac Arrest: 1:10,000 - 1 mg IVP or 2 mg ETT, repeat 5 minutes, PRN
   

2. •Anaphylaxis/Asthma: 1:1000 - 0.3 mg SC
   

3. •Infusion: 4 mg in 250 NS (16 mcg/ml) – condition dependant
   

Pediatric:

Cardiac Arrest:

1:10,000 - 0.01 mg/kg, IV, IO or 1:1000, 0.1 mg ETT, repeat 5 minutes

1:1000 - 0.1 mg/kg IV/IO/ETT, PRN

Anaphylaxis/Asthma:

    1:1000 - 0.1 mg/kg SC to a maximum of 0.3 mg

Nebulized:

< 1 year AND < 5 kg - 0.5 mg in 2 ml NS (1:1000 solution)

< 1 year AND > 5 kg - 2.5 mg (1:1000 solution)

> 1 year - 5 mg (1:1000 solution)

Infusion: 4 mg in 250 NS (16 mcg/ml) – condition dependant

Kinetics

Intravenous

Onset           < 2 minutes

Peak             < 5 minutes

Duration      5 – 10 minutes

Subcutaneous

Onset          10  minutes

Peak            20  minutes

Duration      20 – 30  minutes

Nebulized

Onset           1-5  minutes

Peak             No documentation found

Duration      1 – 3  minutes

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