Adrenaline

Question 1

Drug Class

Answer 1

Sympathomimetic

Question 2

Pharmacology

Answer 2

A naturally occurring catecholamine which primarily acts on Alpha & Beta adrenergic receptors. This = increase in HR, increase in the force of myocardial contraction, increase in irritability of the ventricles, bronchodilation & peripheral vasoconstriction.

Question 3

Metabolism

Answer 3

Majority metabolised by sympathetic nerve endings. It’s subject to the process of mitochondrial enzymatic breakdown of monoamine oxidase at synaptic level

Question 4

Indications

Answer 4

• Cardiac arrest
• Anaphylaxis OR severe allergic reaction
• Severe life-threatening bronchospasm OR silent chest (single words / haemodynamically compromised / AND/OR ALOC
• Shock unresponsive to adequate fluid resus (excluding haemorrhagic, obstructive & anaphylactic)
• Bradycardia with poor perfusion (unresponsive to atropine AND/OR transcutaneous pacing)
• Croup (moderate to severe)

Question 5

Contraindications

Answer 5

Nil

Question 6

Precautions

Answer 6

• Hypertension
• Hypovolaemic shock
• Concurrent MAOI therapy
• Quetiapine therapy

Question 7

Side effects

Answer 7

• Anxiety
• Hypertension
• Palpitations / tachyarrhythmias
• Pupil dilation
• Tremor

Question 8

Presentation

Answer 8

• 1mg/1ml (1:1000)
• 1mg/10ml
• 300mcg epi-pen
• 150mcg epi-pen

Question 9

Onset

Duration

Answer 9

IV 30sec
IM 60sec

5-10min

Question 10

Adult Dosages

Answer 10

Cardiac arrest
• IV 1mg, repeated at 3-5mins, no max dose

Anaphylaxis OR severe allergic reaction
• IM 500mcg, repeated at 5mins, no max dose
• NEB 5mg, single dose only

Severe life-threatening bronchospasm OR silent chest
• IM 500mcg, repeated at 5mins, no max dose

Question 11

Paediatric dosages

Answer 11

Cardiac arrest
IV 
• ≥10kg or 1yr - 10mcg/kg
• <10kg (excl. newly born) - 100mcg
• Newly born - 50mcg
Repeated at 3-5min, no max dose

Anaphylaxis OR severe allergic reaction
IM
• ≥6years ‐ 300mcg
• 1-6yrs - 150mcg
• 6mo-1yr - 100mcg
• <6mo - 50mcg 
* Repeated at5minuteintervals. No max dose.
NEB 
• 5mg, single dose only
* May be admin for upper airway obstruction throught to allergic in origin but IM adrenaline must also be used

Severe life-threatening bronchospasm OR silent chest (single words AND/OR haemodynamic compromise AND/OR ALOC)
IM
• ≥6years ‐ 300mcg
• 1-6yrs - 150mcg
• 6mo-1yr - 100mcg
• <6mo - 50mcg
* Repeated at5minuteintervals. No max dose.

Croup (moderate to severe)
NEB
• 5mg, single dose only