Adrenaline-D (epinephrin) ampoules 0.18% 1ml. №10

active ingredient: epinephrine;

1 ml of solution contains adrenaline tartrate 1.82 mg;

excipients: sodium metabisulphite (E 223), sodium chloride, water for injection.

Injection.

Basic physical and chemical properties: transparent colorless liquid.

Drugs affecting the cardiovascular system. Non-glycoside cardiotonic agents. Adrenergic and dopaminergic drugs. ATX code C01C A24.

Cardiostimulating, vasoconstrictor, hypertensive, antihypoglycemic agent.

The drug stimulates α- and β-adrenergic receptors of various localization. It has a pronounced effect on the smooth muscles of internal organs, the cardiovascular and respiratory systems, activates carbohydrate and lipid metabolism.

The mechanism of action is due to the activation of adenylate cyclase on the inner surface of cell membranes, an increase in the intracellular concentration of cyclic adenosine monophosphate (cAMP) and Ca2 +. The first phase of action is primarily due to stimulation of β-adrenergic receptors of various organs and is manifested by tachycardia, increased cardiac output, excitability and conduction of the myocardium, arteriolo- and bronchodilation, decreased uterine tone, mobilization of glycogen from the liver and fatty acids from fatty depots. In the second phase, excitation of α-adrenergic receptors occurs, which leads to vasoconstriction of the abdominal organs, skin, mucous membranes (skeletal muscles – to a lesser extent), an increase in blood pressure (mainly systolic), and total peripheral vascular resistance.

The effectiveness of the drug depends on the dose. At very low doses, at an administration rate of less than 0.01 mcg/kg/min, it may lower blood pressure due to skeletal muscle vasodilatation. At an injection rate of 0.04-0.1 µg/kg/min, it increases the frequency and strength of heart contractions, stroke volume and minute blood volume, and reduces the total peripheral vascular resistance; above 0.2 mcg / kg / min – constricts blood vessels, increases blood pressure (mainly systolic) and total peripheral vascular resistance. The pressor effect can cause a short-term reflex slowing of the heart rate. Relaxes the smooth muscles of the bronchi. Doses above 0.3 mcg/kg/min reduce renal blood flow, blood supply to internal organs, tone and motility of the gastrointestinal tract.

Increases conductivity, excitability and automatism of the myocardium. Increases myocardial oxygen demand. It inhibits the release of histamine and leukotrienes induced by antigens, eliminates spasm of bronchioles, and prevents the development of edema of their mucous membrane. Acting on α-adrenergic receptors of the skin, mucous membranes and internal organs, it causes vasoconstriction, a decrease in the rate of absorption of local anesthetics, increases the duration of action and reduces the toxic effect of local anesthesia. Stimulation of β2-adrenergic receptors is accompanied by increased excretion of potassium from the cell and can lead to hypokalemia. With intracavernous administration, it reduces the blood filling of the cavernous bodies.

It dilates the pupils, helps to reduce the production of intraocular fluid and intraocular pressure. It causes hyperglycemia (increases glycogenolysis and gluconeogenesis) and increases the content of free fatty acids in the blood plasma, improves tissue metabolism. Weakly stimulates the central nervous system, has anti-allergic and anti-inflammatory effects.

The therapeutic effect develops almost instantly with intravenous administration (duration of action – 1-2 minutes), 5-10 minutes after subcutaneous administration (maximum effect – after 20 minutes), with the introduction of the onset of the effect is variable.

• Allergic reactions of immediate type: anaphylactic shock that has developed with the use of drugs, serums, blood transfusions, insect bites or contact with allergens.
• Bronchial asthma – relief of an attack.
• Arterial hypotension of various origins (posthemorrhagic, intoxication, infectious).
• Hypoglycemia due to insulin overdose.
• Asystole, cardiac arrest.
• Prolongation of action of local anesthetics.
• AV-blockade of the III degree, developed acutely.

Hypersensitivity to the components of Adrenaline (epinephrine); hypertrophic obstructive cardiomyopathy, severe aortic stenosis, tachyarrhythmia, ventricular fibrillation, pheochromocytoma, glaucoma, shock (except for anaphylactic shock), general anesthesia with the use of inhalants: halothane, cyclopropane, chloroform; II period of childbirth; application on areas of fingers and toes, on areas of the nose, genitals.