Adrenaline (epinephrin) solution for injections ampoules 1.82 mg/ml. 1ml. №10

Description

Composition

active ingredient: epinephrine;

1 ml of solution contains adrenaline tartrate 1.82 mg;

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

Pharmacodynamics.

Cardiostimulating, vasoconstrictor, hypertensive, antihypoglycemic agent.

Adrenaline (epinephrine) solution stimulates α- and β-adrenoceptors of different 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 caused, first of all, by stimulation of β-adrenoceptors of various organs and is manifested by tachycardia, increased cardiac output, excitability and conductivity of the myocardium, arteriolo- and bronchodilation, decrease in uterine tone, mobilization of glycogen from the liver and fatty acids from fat depots. In the second phase, α-adrenoceptors are stimulated, which leads to the narrowing of blood vessels in the abdominal organs, skin, mucous membranes (skeletal muscles to a lesser extent), an increase in blood pressure (mainly systolic), and general peripheral vascular resistance.

The effectiveness of epinephrine depends on the dose. In very low doses, at an administration rate of less than 0.01 mcg/kg/min, it can lower blood pressure due to dilation of skeletal muscle vessels. At the rate of administration of 0.04–0.1 μg/kg/min, it increases the frequency and strength of heart contractions, stroke volume and minute volume of blood, reduces total peripheral vascular resistance; above 0.2 μg/kg/min – narrows blood vessels, increases blood pressure (mainly systolic) and general 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 μg/kg/min reduce renal blood flow, blood supply to internal organs, tone and motility of the gastrointestinal tract.

Adrenaline (epinephrine) Indications 

• Allergic reactions of the immediate type: anaphylactic shock that developed when using drugs, serums, blood transfusions, insect bites or contact with allergens.
• Bronchial asthma – stopping an attack.
• Arterial hypotension of various genesis (posthemorrhagic, intoxication, infectious).
• Hypoglycemia due to insulin overdose. Asystole, cardiac arrest.
• Extending the effect of local anesthetics.
• AV blockade of the III degree, which developed acutely.

Contraindications

• Increased sensitivity to the components of the medicinal product;
• hypertrophic obstructive cardiomyopathy, severe aortic stenosis, tachyarrhythmia, ventricular fibrillation, pheochromocytoma, angle-closure glaucoma, shock (except anaphylactic), general anesthesia with the use of inhalation agents: flurothane, cyclopropane, chloroform;
• II period of childbirth;
• application on areas of fingers and toes, on areas of the nose, genitals.

Dosage and administration

Assign intramuscularly, subcutaneously, sometimes – intravenously, intracardiac (resuscitation during cardiac arrest). When administered intramuscularly, it begins to act faster than when administered subcutaneously. Dosing regimen is individual.

Adults.

Anaphylactic shock: inject slowly intravenously 0.5 ml, diluted in 20 ml of 40% glucose solution. In the future, if necessary, continue intravenous drip at a rate of 1 μg / min, for which 1 ml of adrenaline solution is dissolved in 400 ml of 0.9% sodium chloride solution or 5% glucose. If the patient’s condition allows, it is better to carry out intramuscular or subcutaneous administration of 0.3–0.5 ml diluted or undiluted.

Bronchial asthma: inject 0.3-0.5 ml subcutaneously diluted or undiluted. If repeated administration is necessary, this dose can be administered every 20 minutes (up to 3 times). Perhaps intravenous administration of 0.3-0.5 ml diluted. As a vasoconstrictor, administer intravenously at a rate of 1 µg/min (with a possible increase to 2–10 µg/min).

Asystole: inject intracardiac 0.5 ml diluted in 10 ml of 0.9% sodium chloride solution. During resuscitation – 1 ml (diluted) intravenously slowly every 3-5 minutes.

Children.

Asystole in infants: Administer slowly intravenously at a dose of 10–30 mcg/kg body weight every 3–5 minutes. Anaphylactic shock: administer subcutaneously or intramuscularly at 10 mcg / kg of body weight (maximum – up to 0.3 mg). If necessary, repeat the introduction every 15 minutes (up to 3 times).

Bronchospasm: inject subcutaneously 10 mcg/kg body weight (maximum – up to 0.3 mg). If necessary, repeat the introduction every 15 minutes (up to 3-4 times) or every 4 hours.