Pharmacology

Therapeutic Uses of Adrenaline

Dr.MehnazLeave a comment

1) Vascular Uses:

(i) Hypotensive States: (Shock, Spinal Anaesthesia)

➡️ In case of anaphylactic shock or angioedema of Larynx or for bronchospasm attending drug hypersensitivity (Adrenaline + sub-class of gluco-corticoids) is recommended.

  • Put the patient in reclining position, administer oxygen at high flow rate
  • Inject adrenaline 0.5 mg (0.5 ml of 1 in 1000 solution for adult, 0.3 ml for child (6-12 years) & 0.15 ml for child (upto 6 years) i.m
  • Repeat every 5-10 min. in case patient does not improve.
  • This is the only life saving measure
👉🏻 Adrenaline should not be injected i.v unless shock is life threatning. Should be diluted to 1:10,000/1:1,00,000 & infused slowly with constant monitoring

(ii) Along with local anaesthetic:

➡️ Adrenaline 1 in 2,00,000 to 1 in 1,00,000 for infilteration, nerve block, spinal anaesthesia

🔅Effects:

  • Duration of anaesthesia prolonged
  • Systemic toxicity of LA ⬇️
  • Local bleeding minimized

(iii) Control of local bleeding: (Skin, mucous membrane eg. Epistaxis)

➡️ Compresses of adrenaline 1 in 10,000 can control arteriolar & capillary bleeding

2) Cardiac Uses:

🔅Cardiac Arrest (Drowning, Stokes-Adam syndrome)

👉🏻 Adrenaline is used to stimulate the heart, i.v infusion with external cardiac massage

3) Allergic disorders:

  • Adrenaline is a physiological antagonist of histamine which is an important mediator of many acute hypersensitivity reaction
  • Affords quick relief in urticaria, angioedema
  • Ineffective in delayed type allergy because histamine not involved.

4) Mydriatic:

👉🏻 The ester prodrug of adrenaline – Dipivefrine is an adjuvant drug for open angle glaucoma

5) Insulin hypoglycaemia:

👉🏻 Adrenaline can be used as an expedient measure but glucose should be given as soon as possible.

Dr. Mehnaz Memon🖊

References: Essentials of Medical pharmacology, KD Tripathi (7th Ed)

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