The adrenal glands are endocrine glands that produce adrenaline. It takes part in the regulation of the cardiovascular system. It is also called the hormone of fear, as it is released into the blood in large quantities during fright, stressful situations, during physical work. But Adrenaline is also produced by the pharmaceutical industry. The instruction contains information that it is obtained from the tissues of the adrenal glands of animals or synthetically. Next, consider what are the indications for its use, how to use it correctly, what are the side effects.
Composition of the drug
The drug is available as epinephrine hydrochloride, which is available as a crystalline substance with a pinkish hue that changes with oxygen and light. There is also a second form - adrenaline hydrotartrate, made in the form of a white powder with a grayish color. Perfectly soluble in water and in liquids containing alcohol.
Dosage forms of adrenaline (the instruction contains such information) are as follows:
- Solution for injection. It is a liquid colorless and transparent substance with a specific odor. Packaged, according to the instructions, adrenaline solution in 1 ml ampoules and packed in boxes of 5 ampoules.
- Solution for external use. This liquid is colorless and slightly colored, has a specific smell. Packaged in 30 ml bottles.
1 ml solution for injection contains 1 mg of epinephrine as the main active ingredient. There are also additional components:
- Sodium disulphite.
- Hydrochloric acid.
- Sodium chloride.
- Chlorobutanol hydrate.
- Glycerin.
- Disodium edetat.
- Injection water.
1 ml of topical product contains the same amount of epinephrine as the main active ingredient and additional ingredients:
- Sodium metabisulphite.
- Sodium chloride.
- Glycerin.
- Chlorobutanol hydrate.
- Disodium edetat.
- 0.01 M hydrochloric acid solution.
According to the instructions for use, the drug "Adrenaline" should be prescribed only by a specialist. Depending on the pathology, the form of the drug is selected.
Therapeutic effect on the body
The active substance of the drug has a strong stimulating effect on α- and β-adrenergic receptors. It leads tothe following body responses:
- Increased calcium content in smooth muscle tissue.
- The work of nerve endings is activated.
- Calcium channels open, allowing the substance to enter the cell.
- Stimulating effect on β receptors enhances cAMP synthesis.
- The frequency and strength of contractions of the heart muscle increases.
- Myocardial oxygen demand increases.
- Vessels located in the skin, mucous membranes narrow.
Instructions for use for "Adrenaline" in ampoules says that the drug relieves spasm of smooth muscles, lowers the tone of the gastrointestinal tract, dilates the pupils, reduces intraocular pressure.
"Adrenaline" after penetration into the bloodstream increases the glucose content and improves metabolism in tissues. Taking the drug helps to increase the efficiency of skeletal muscles, which is especially necessary with severe fatigue, during exhausting physical exertion.
Specialists note that adrenaline hydrochloride and adrenaline hydrotartrate give the same therapeutic effect, but given the difference in molecular weight, the latter drug can be given at a higher dosage.
In what cases is the drug indicated
Instructions for the drug "Adrenaline" examines in detail the indications for prescribing the drug. The drug is prescribed for such pathologies and conditions:
Low blood pressure thatcannot be corrected by the introduction of replacement fluids. This often happens with injuries, shock, after surgery on the open heart, with the development of heart and kidney failure
- Asthma or bronchospasm due to anesthesia.
- Bleeding from vessels located in the superficial layers of the skin.
- Allergic reactions that develop after the introduction of drugs, insect bites, eating food, after blood transfusion.
- Insulin overdose resulting in hypoglycemia.
- Open-angle glaucoma.
- Surgery on the eyes to dilate the pupil.
In the instructions for the drug "Adrenaline" there is also a mention that the drug is able to prolong the period of action of local anesthetics.
Contraindications to the use of Adrenaline
Do not administer the drug under the following conditions:
- Severe atherosclerosis.
- High blood pressure.
- Bleeding of any etiology.
- Period of bearing a baby.
- Breastfeeding.
- Increased sensitivity to drug ingredients.
- According to the instructions for use, Adrenaline in ampoules should not be used if general anesthesia is given using Cyclopropane, Fluorothane or Chloroform.
Any disregardcontraindications can lead to serious complications that are life-threatening for the patient. It is better not to self-medicate using Adrenaline, so as not to complicate the situation.
Negative effects of drug therapy
If the instructions for the Adrenaline medicine are not followed, then there is a high probability of developing side effects that affect the functioning of internal organs:
- The gastrointestinal tract may react with: nausea, vomiting, loss of appetite.
- Difficulties with urination, men still have prostatic hyperplasia.
- Metabolic processes are characterized by a decrease in potassium concentration and hyperglycemia.
- On the part of the nervous system, there is: headache, tremor of the limbs, increased nervous excitability, muscle tic, in patients diagnosed with parkinsonism, stiffness increases.
- The patient's psycho-emotional state is changing: increased anxiety appears, the ability to navigate in space is lost, memory deteriorates, and temporary amnesia may be observed, a schizophrenic-like state is noted.
- The cardiovascular system cannot but respond to the drug: angina pectoris develops, heart rate increases, chest pains appear, heart rhythm disturbances, ECG data are distorted, blood pressure surges.
- Bronchial spasm or angioedema.
- Skin may develop rashes, erythema develops.
Among other body reactions, patientsnote:
- Fatigue.
- Swelling and soreness appear at the injection site.
- Hands and feet get cold.
- Thermoregulation is disturbed.
- Excessive sweating.
If a repeated injection was carried out, then there is a high probability of necrosis of tissues, kidneys and liver, which is caused by a sharp narrowing of the lumen of blood vessels. Therefore, therapy should be carried out only under medical supervision in a hospital, so that, if necessary, the patient can be provided with urgent assistance.
Overdose symptoms
If "Adrenaline" is prescribed, and the doctor's instructions and recommendations are not followed, then an overdose of the drug is possible. Exceeding the administered dose is manifested by the following symptoms:
- Sudden increase in blood pressure.
- Tachycardia.
- Irregular heart rhythm.
- Pale skin.
- Freezing hands and feet.
- Profuse vomiting.
- Fear, increased anxiety, depression.
- Headache.
- Metabolic acidosis.
- Elderly patients are at high risk of cerebral hemorrhage.
- Development of kidney failure.
- Accumulation of fluid in the lungs.
- In the most serious cases, death.
If a patient's life-threatening condition develops against the background of Adrenaline injections, the instruction recommends immediately stopping the administration of the drug. To relieve the patient's conditionadrenoblockers, LS-nitrates with a quick effect are used. In a situation where the patient is very ill, a whole range of measures is taken to restore the functioning of internal organ systems.
Scheme of administration and dosage
"Adrenaline" is not a drug that you can prescribe yourself. Only the doctor should decide on the need for therapy. According to the instructions, Adrenaline 0.1% is recommended to be administered intramuscularly, subcutaneously or by drip into a vein. The method and dosage are determined taking into account the patient's condition and the existing diagnosis.
General recommendations are:
- To eliminate anaphylactic shock, the drug "Adrenaline" in ampoules, the instruction recommends administering intravenously at a dosage of 0.1 to 0.25 mg. For dilution, use 10 ml of isotonic solution. If necessary, you can administer the drug drip, if the patient tolerates the drug well, then the dosage can be from 0.3 to 0.5 mg of the active substance. If you need to re-administer the medicine, then this should be done at intervals of at least 20 minutes, but no more than three times.
- During an asthma attack, as follows from the instructions for use, Adrenaline 0.1% should be administered subcutaneously at a dosage of 0.3-0.5 mg in diluted or pure form. The next injection can be given only after 20 minutes, if there is no improvement. For injection into a vein, the drug must be diluted with saline.
- The use of a drug to enhance the action of localanesthetics. In such cases, the dosage depends on the medication used. The average amount is 5 µg/ml. In order to enhance anesthesia of the spinal cord, 0.2-0.4 mg of Adrenaline is used.
The use of the drug in the treatment of children is also allowed.
"Adrenaline" in pediatric practice
Depending on the diagnosis and condition of a small patient, the following treatment regimens and dosages are used:
- To eliminate the consequences of anaphylaxis, children are given the drug subcutaneously or intramuscularly. The dosage is taken at the rate of 10 mcg per 1 kg of the child's weight. The maximum dosage should not exceed 0.3 mg. Injections can be done no more than 3 times with a 15-minute break.
- To relieve bronchospasm, 0.01 mg per kilogram of the child's weight is taken and injected subcutaneously. An injection can be given every 15 minutes, but no more than 4 times. If an infusion is required, then, according to the instructions for Adrenaline in ampoules, the drug is recommended to be injected into large veins.
Therapy in childhood should only be carried out under the supervision of doctors. It is simply unacceptable to prescribe medicine to a baby on your own.
Injection of the drug into the heart muscle
Cinema often demonstrates how to inject Adrenaline directly into the heart muscle. But now experts consider this method ineffective and provoking a lot of undesirable consequences, even if it is possible to bring a person back to life. Brain activity suffers and the likelihood of developing neurological abnormalities is high, and survival does not depend on this in any way.
If the heart musclestopped, then "Adrenaline" is administered as an injection and combined with chest compressions, and in a hospital setting, a defibrillator is used.
Drug during pregnancy
Instructions for "Adrenaline" indicates the high activity of the active ingredient of the drug, which allows it to easily cross the placenta and into breast milk. Special studies on this subject have not been conducted, but it is not recommended to carry out drug therapy in an interesting position for women and during breastfeeding.
According to the instructions, the drug "Adrenaline" in ampoules can be prescribed to expectant mothers if the benefit to her outweighs the possible harm to the fetus. This issue is decided only by the attending physician.
Important nuances of therapy
For the successful implementation of therapy and the prevention of undesirable consequences, it is necessary to adhere to some recommendations:
- During treatment, it is necessary to constantly monitor blood pressure, cardiogram readings, potassium ions and other important indicators.
- Too high doses during a heart attack can increase the heart muscle's need for oxygen, which will provoke an increase in the manifestations of the pathology.
- Adrenaline increases the concentration of glucose, so patients with diabetes need to adjust the dosage of the injected "Insulin".
- Prolonged therapy can cause severe narrowing of the lumen of blood vessels, which is fraught with the development of tissue necrosis.
- The drug is not recommended for women in labor who have lowblood pressure, as the second stage of labor may slow down.
- High doses to eliminate uterine contractions can provoke atony of the organ and the development of bleeding.
According to the instructions for use, children and adults are advised to cancel Adrenaline gradually, reducing the dosage, as abrupt cancellation will provoke a drop in blood pressure.
Interaction with other drugs
When prescribing a drug, it is important to consider how it can be combined with other medications:
- Reception simultaneously with painkillers and sleeping pills reduces the therapeutic effect of the latter.
- The joint administration of "Adrenaline" with heart medications, "Quinidine", drugs for inhalation anesthesia and cocaine-containing drugs provokes heart rhythm disturbance. This combination should be avoided, in case of an urgent need for therapy, it is important to prepare funds for emergency resuscitation.
- Combination with drugs that have a side effect of complications of the heart, may lead to increased negative effects.
- The effectiveness of diuretic drugs is declining.
- Concomitant use with antidepressants is dangerous with a sharp jump in blood pressure, severe headache, development of arrhythmia.
- "Adrenaline" weakens the effect of nitrates.
- The effect of drugs containing thyroid hormones is enhanced.
"Adrenaline hydrochloride" lengthens the QT interval on the cardiogram, enhances the therapeuticeffect of the use of drugs with iodine. Special care must be taken when co-administered with medications containing ergot alkaloids. It can cause ischemia and increase the risk of gangrene, as well as reduce the effect of drugs taken to treat insulin.
It is impossible to mix "Adrenaline" with other drugs in one syringe, so as not to distort its effect.
"Adrenaline" with "Furacilin"
Instructions for use contains information that the tool can be used in the treatment of children and adults. This can be explained by the specific action of the constituent components:
- Furacilin has antiseptic properties.
- "Adrenaline" constricts blood vessels.
The use of drops containing these two components is practiced in the treatment of the nasopharynx. The remedy is used for the following conditions and pathologies:
- For the treatment of sinusitis with purulent discharge.
- For washing the nasal cavity.
- In the complex therapy of bacterial infections.
- For the treatment of prolonged rhinitis.
- To ease breathing when other remedies fail to relieve congestion.
- For the treatment of inflammatory processes in the sinuses.
- With the development of adenoiditis, sinusitis.
"Furacilin" relieves swelling and relieves nasal congestion, "Adrenaline" constricts blood vessels and reduces the production of mucous secretions. Drops help to cope with problems in the nasal cavity, provoked by viruses or bacteria.
"Adrenaline" with "Furacilin" (the instruction mentions this) is prescribed only by the attending physician, indicating the exact regimen and dosage. The duration of therapy is from three to seven days, but not more than a week.
Recommendations for the use of the tool are as follows:
- Thoroughly clean the nasal cavity from mucus and crusts. You can speed up the process by using saline solutions, purchased from a pharmacy or prepared by yourself.
- Heat drops a little to body temperature. To do this, just hold the bottle in your hands for a while.
- Drip 1-3 drops into each nasal passage, repeat the procedure three times a day.
- Brush your nose after 10-15 minutes.
For the treatment of small children, you can use an aspirator. Drops can also be used as an external injection. Effective use for inhalation. If the child is from one year to 6 years old, then 10 drops of the drug for one procedure are enough. Repeat for maximum effectiveness at least 3 times a day.
For babies, the product contains:
- Aqueous adrenaline solution.
- Furacilin.
- Boric acid solution.
- "Ephedrine".
- Salicylic sodium solution.
It is recommended for babies to instill drops into the nose 15 minutes before feeding, 1-2 drops. If the nasal passages are very clogged, then before the procedure it is necessary to remove the mucus with a syringe.
The use of the product should be carried out only after consultation with a pediatrician. It is strictly forbidden to exceed the recommendeddosage.
Therapy with any medication should be carried out with the permission of the doctor. This is especially true of such serious medications as Adrenaline. Self-medication and uncontrolled intake can turn into disastrous consequences.
