Adrenaline + Sodium Metabisulphite Pharmacology
Adrenaline + Sodium Metabisulphite
1.Adults:0.3 to 0.5 mL (0.3-0.5mg), administered slowly. The dose may be repeated every 10 minutes if necessary. In severe reactions the dose can be increased to 1mL.
2.Elderly patients:The usual adult dose is used but should be given very slowly with caution as elderly patients may be more sensitive to adrenaline.
3.Children (up to 12 years of age):100 - 500ug depending on age, or 50ug for infants under 1 year
2.Severe hypertension leading to pulmonary oedema and cerebral haemorrhage.
3.Overdosage of adrenaline can result in severe metabolic acidosis because of elevated blood concentration of lactic acid.
Adrenaline
Subcutaneous: 5 to 15minutes
Inhalation: Within 5 minutes
I.V.: Short
Subcutaneous: 1 to 4 hours
Inhalation: 1 to 3 hours
2.Hypertension
3.Tachycardia
4.Ventricular fibrillation
5.Shock
6.Anginal pain
7.ECG changes
8.Arrhythmias
9. Tremor
10.Nervousness
11.Headache
12.Vertigo
13.Disorientation
14.Agitation
15.Dizziness
16.Drowsiness
17.Fear
18.Weakness
19.Lightheadedness
20.Nervousness
21.Excitation
22.Dyspnoea
23.Nausea
24.Vomiting.
2.Shock other than anaphylactic shock,
3.Angle closure glaucoma,
4.Anaesthesia of extreamities,
5.During labour,
6.Cardiac dilatation,
7.Coronary insufficiency,
8.Organic brain damage,
9.Cerebral arteriosclerosis,
10.Arrhythmias,
11.Along general anaesthesia with halogenated hydrocarbons or cyclopropane.
2.Emphysema
3.Hyperthyroidism
4.Cardiovascular disease
5.Psychoneurosis
6.Diabetes
7.Parkinson`s disease(ophthalmic preparation)
2.Bronchodilator
3.Hypersensitivity reactions
4.Anaphylactic shock
5.To restore cardiac rhythm in cardiac arrest
6.Haemostasis
7.Prolong duration of anaesthesia
8.Nasal congestion
9.Open angle glaucoma.
Cardiac glycosides: May make cardiac arrhythmias more likely.
Ergot alkaloids and phenothiazines: May reverse the pressor effects of adrenaline.
Antihistamines: Pressor effect may be potentiated.
Halogenated hydrocarbon anaesthetics: Sensitise the myocardium to the effects of catecholamines leading to serious arrhythmias.
Oxytocic drugs: May cause severe persistent hypertension.
Sympathomimetic drugs: Additive effects and increased toxicity. May induce serious cardiac arrhythmias.
Tricyclic antidepressants: Pressor response may be potentiated.
Adults: Starts with 0.1 to 0.5mg (0.1 to 0.5ml of a 1: 1,000 solution) S.C. or I.M. Repeat as required at 10 to 15minute intervals. Alternatively 0.1 to 0.25mg (1 to 2.5ml of a 1: 10,000 solution) I.V.; slowly over 5 to 10 minutes. Repeated if required at every 5 to 15minutes or followed by 1 to 4mcg/minute I.V. infusion.
Children: 0.01mg/kg (0.01ml/kg of a 1: 1000 solution) S.C. Dose not to exceed 0.5mg. Repeated as required; at every 20 minutes to 4hour intervals. Alternatively 0.02 to 0.025 mg/kg (0.004 to0.005 mi/kg) of a 1:200 solution. Repeat if required but not to exceed than four times daily. Alternatively
To restore cardiac rhythm in cardiac arrest:
Starts with 0.5 to 1mg (5 to 10ml of 1: 10,000 solutions) diluted to 10ml and administered I.V. or intra cardiac. During resuscitation 0.5 to 1mg I.V. every 5minutes or injected through endotracheal tube. Administer 10ml containing 1ml adrenaline (0.1mg/ml) by 5 rapid insufflations directly in to the tube and followed by 5 rapid insufflations.
Adults: I.V.: 100mcg to 250mcg injected slowly.
Neonates: 0.01mg/kg
Infants: 50mcg initial dose repeated at 20 to 30 minutes intervals in asthma attacks.
Resuscitation for children and neonates: 0.iml/kg of 1: 10000solution I.V.
As a haemostatic agent:
Adults: 1: 50,000 to 1: 1000 applied topically.
To prolong local anaesthetic effect: 1:500000 to 1: 50000 mixed with local anaesthetic agent.
Intra spinal use: 0.2 to 0.4ml of 1: 2000 solutions added to anaesthetic fluid to prolong anaesthetic action.
Nasal congestion, local superficial bleeding: Instill 1 to 2 drops of solution.
Open angle glaucoma: 1 to 2 drops instill daily or twice daily.
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