The hormone adrenaline can activate everything in a matter of seconds. protective functions the body in order to react in time to a dangerous situation and take urgent measures. It is not surprising that solutions of adrenaline hydrochloride and adrenaline hydrotartrate are successfully used as bronchodilators, vasoconstrictors, antiallergic, hyperglycemic agents, and drops are prescribed for glaucoma.
Timely administration of solution during myocardial infarction and other dangerous diseases can save a human life.
The natural hormone adrenaline (in Latin - “adrenaline”) is produced by the adrenal medulla and in its own way chemical structure considered a catecholamine. That's what they call physiologically active substances, which are not only hormones that regulate the activity of the body, but also neurotransmitters, since interacting with the central nervous system, they influence the speed of thinking, perception of information, aggressiveness, emotional stability, and shape behavior.
The synthesis of adrenaline and its release into the blood increases sharply with severe fear, excitement, or intense exercise. In response to this, the blood vessels of the skin, mucous membranes, and organs immediately narrow abdominal cavity, skeletal muscles, which leads to an increase blood pressure due to a decrease in the diameter of the blood channels, as well as increased heartbeat.
During the action of the hormone, the blood vessels of the heart and brain dilate, and the pupils enlarge. To overcome a life-threatening situation, adrenaline temporarily turns off the digestive, genitourinary systems, increases the breakdown of glycogen and fats. Cells begin to absorb glucose better, as a result of which the body receives additional energy, which leads to increased endurance.
The effect of adrenaline is short-lived and in a normal situation lasts no more than five minutes. This effect of the hormone on the body is possible due to the fact that as soon as adrenaline enters the blood, it begins to affect adrenergic receptors located on the cells of target organs, which leads to structural change in the structure of protein molecules that trigger intracellular reactions, forming a physiological response to irritation. At the same time, hormones produced by the thyroid gland, as well as glucocorticoids, increase the sensitivity of receptors to the hormone.
Hormone analogues
The drugs adrenaline hydrochloride hydrotartrate (in Latin - adrenalini hydrochloridum) and adrenaline hydrotartras (adrenalini hydrotartras) have a similar effect on the body. structural formula which is similar to a natural hormone.
The drug itself is a white or pinkish powder; the medicine is supplied to the buyer in the form of a 0.1% solution in 30 ml jars, as well as in 1 ml ampoules. The adrenaline solution is characterized by a transparent color; it should not contain sediment or other undissolved substances.
Like a natural hormone, artificial adrenaline affects alpha and beta adrenergic receptors and also excites nerve fibers. Although the use of the drug in therapeutic doses has no particular effect on central nervous system does not provide side effect There may be anxiety, migraine, tremors of the limbs.
It should be noted that the effect of adrenaline hydrotartrate and adrenaline hydrochloride on the frequency heart rate ambiguous. On the one hand, activation of adrenergic receptors accelerates the heart rate, on the other hand, due to an increase in blood pressure, the center is activated vagus nerves, which inhibits the activity of the heart, so when reduced content of oxygen in the body, arrhythmia may occur.
Like a natural hormone, the medicine affects vision by dilating the pupils. Therefore, drops of adrenaline in pure form or as part of drops that include furatsilin, according to a doctor’s prescription, they are successfully used to treat glaucoma. Also, the adrenaline solution relaxes the muscles of the intestines and bronchi: there are many positive reviews on the Internet about the effect of the medicine during attacks bronchial asthma.
Injecting a solution of adrenaline hydrotartrate or adrenaline hydrochloride accelerates tissue metabolism in the body, increases the amount of glucose in the body, and restores the functioning of skeletal muscle tissue, which is important when overworked.
Adrenaline hydrochloride solution is dispensed by prescription for the following indications:
- during exacerbations of bronchial asthma;
- at acute heart attack myocardium, when chaotic heart rhythm is observed;
- a sharp drop in blood pressure, which can be caused by an overdose medicines, allergies, insect bites;
- when the amount of sugar in the blood decreases due to an overdose of insulin drugs (hypoglycemia);
- for acute allergies;
- for glaucoma and other eye problems (as solution drops or in combination with other drugs, for example, where there is furatsilin);
- as a vasoconstrictor medicine for the treatment of ear, nose, throat (drops containing furatsilin).
A prescription is also prescribed for allergic swelling of the larynx and anaphylactic shock. Tampons soaked in the solution are used to stop bleeding. Timely use of the drug during unexpected cardiac arrest can save a person's life.
Action of the medicine
The effect of the drugs on the body is not much different from each other, the only difference is in the relative molecular weight: for hydrotartrates it is higher and amounts to 333.3, while for hydrochloride it is 219.66. When a doctor writes a prescription, adrenaline hydrotartrate solution is prescribed in larger quantities.
Depending on the disease and the degree of the disease, the recipe provides for administering the solution subcutaneously, intramuscularly, intravenously, for glaucoma and ENT diseases - as drops (drops containing furatsilin help well). The dose usually ranges from 0.3 to 0.75 ml of a 0.1% solution; for glaucoma, a 1-2% solution in drops is prescribed (the doctor will tell you exactly how to use the drops).
How quickly the adrenaline hydrochloride solution will act largely depends on the speed of administration of the drug:
- When administered at a dose of up to 0.2 mcg/kg/min, the drug enhances and increases heart rate, increases minute and stroke volume of blood flow, and reduces resistance vascular system the flow of blood that the heart ejects.
- If the dose in the prescription exceeds 0.2 mcg/kg/min, a solution of adrenaline hydrotartrate or epinephrine hydrochloride constricts blood vessels, increases blood pressure and further reduces vascular resistance to the flow of blood emitted by the heart. This effect can provoke short-term bradycardia (decreased heart rate), and also relaxes the smooth muscles of the bronchi.
- At a dose above 0.3 mcg/kg/min, blood supply decreases during internal organs, renal blood flow, activity digestive system.
Also, the speed of the solution’s effect on the body largely depends on how it was administered. When administered intravenously, the action is immediate and the effect lasts from one to two minutes (usually used in critical situations, for example, in cardiac arrest). The effect of the medicine after subcutaneous injection begins within five to ten minutes, the maximum effect occurs after twenty minutes. The beginning of the effect of adrenaline solution on the body when intramuscular injection difficult to predict.
Contraindications and side effects
There are many diseases for which the drug must be used carefully, so before the doctor writes a prescription, you need to warn the doctor about the diseases and also study the instructions. First of all, the medicine should not be used by people with high blood pressure or the elderly. The medicine is also contraindicated:
- with atherosclerosis – chronic disease arteries due to disturbances in lipid and protein metabolism, accompanied by cholesterol deposits in the vessels;
- with thyrotoxicosis – increased synthesis of iodine-containing thyroid hormones;
- at diabetes mellitus because the drug increases the amount of glucose in the blood;
- during pregnancy and during breastfeeding;
- increased sensitivity to adrenaline.
The medicine must be used strictly as prescribed by the doctor according to the prescribed prescription, since even use according to the instructions can cause dizziness, feelings of anxiety, fear, trembling of the limbs and other ailments associated with the functioning of the nervous system. Patients with coronary heart disease should be aware that when using the solution, the likelihood of angina pectoris increases. Disturbances in the digestive system are possible, which manifests itself in vomiting, nausea, and possibly painful urination.
After administering adrenaline hydrochloride solution due to narrowing blood vessels, for some time, pale skin, sweating, and increased blood pressure are often observed. This effect of the drug on the body is short-term and is not a reason for correcting or discontinuing the drug. An overdose of the drug is life-threatening: in this case, the patient’s pupils instantly dilate, blood pressure increases, and the heartbeat quickens, which can provoke a chaotic heart rhythm.
Adrenaline hydrochloride cannot be used simultaneously with many medications, so you need to inform your doctor about the medications you are using, as their interaction may provoke death. The use of adrenaline hydrochloride is prohibited for patients who are using sleeping pills or narcotic drugs. Also, the drug is incompatible with antihistamines, inhalation anesthesia.
What is adrenaline and where is adrenaline produced?
Adrenaline is a hormone that is produced in adrenal medulla - a structure regulated by the nervous system, which is the main source for the body catecholamine hormones — ,adrenaline And norepinephrine .
Adrenaline used as medicine, obtained from the adrenal tissue of slaughtered cattle or synthetically.
Epinephrine - what is it?
International generic name adrenaline (INN) - epinephrine .
For medicine, the drug is produced pharmaceutical companies as adrenaline hydrochloride (Adrenalini hydrochloridum) and in the form adrenaline hydrotartrate (Adrenalini hydrotartras).
The first is a white or white with a pinkish tint powder with a crystalline structure, which has the ability to change its properties under the influence of light and oxygen contained in the air.
In the process of preparing the solution, O, O1 N is added to the powder. hydrochloric acid solution. For preservation, chlorobutanol and sodium metabisulfite are used. The finished solution is transparent and colorless.
Adrenaline hydrotartrate is a white or white with a grayish tint powder with a crystalline structure that has the ability to change its properties under the influence of light and oxygen contained in the air.
The powder is highly soluble in water, but slightly soluble in alcohol. Unlike adrenaline hydrochloride solutions aqueous solutions adrenaline hydrotartrate are characterized by greater stability, but in their action they are absolutely identical to them.
Due to the difference in molecular weight (for hydrogen tartrate it is 333.3, and for hydrochloride it is 219.66), hydrogen tartrate is used in a larger dose.
Release form
Pharmaceutical companies produce medicine in the form of:
- 0.1% solution of adrenaline hydrochloride;
- 0.18% solution of adrenaline hydrogen tartrate.
The product is supplied to pharmacies in ampoules made of neutral glass. The volume of the product in one ampoule is 1 ml.
A solution intended for local application, sold in hermetically sealed orange glass bottles. The capacity of one bottle is 30 ml.
Adrenaline tablets are also available in pharmacies. The drug is available in the form of homeopathic D3 granules.
pharmachologic effect
Wikipedia states that adrenaline belongs to the group catabolic hormones and has an effect on almost all varieties metabolism . It helps to increase the level contained in blood sugar and stimulates tissue exchange .
Adrenaline simultaneously belongs to two pharmacological groups:
- Medicines that have a stimulating effect on α and α+β-adrenergic receptors.
- Hypertensive drugs.
The drug is characterized by its ability to provide:
- hyperglycemic ;
- bronchodilator ;
- hypertensive ;
- antiallergic ;
- vasoconstrictor effects .
In addition, the hormone adrenaline:
- has an inhibitory effect on production glycogen in skeletal muscle and liver ;
- promotes increased capture and utilization glucose fabrics;
- increases activity glycolytic enzymes ;
- stimulates decay and suppresses synthesis (a similar effect is achieved due to the ability of adrenaline to influence β1-adrenergic receptors , localized in adipose tissue );
- increases functional activity skeletal muscle tissue (especially with severe fatigue);
- stimulates CNS (generated at borderline (i.e. dangerous for human life) situations, provokes an increase in the level of wakefulness, increases mental activity and mental energy, and also promotes mental mobilization);
- excites the area that is responsible for the production corticotropin releasing hormone ;
- activates the system adrenal cortex-pituitary gland-hypothalamus ;
- stimulates production adrenocorticotropic hormone ;
- stimulates function blood coagulation system .
Adrenaline has antiallergic And anti-inflammatory effect , preventing release mediators of allergy and inflammation (leukotrienes , histamine , etc.) from mast cells, exciting localized in them β2-adrenergic receptors and reducing the level of sensitivity of various tissues to these substances.
Moderate concentrations of adrenaline have trophic effect on skeletal muscle tissue and myocardium , in high concentrations the hormone enhances protein catabolism .
Pharmacodynamics and pharmacokinetics
The gross formula of adrenaline is C₉H₁₃NO₃.
Adrenaline and other substances that are produced adrenal glands , have the ability to interact with various tissues of the body and thereby prepare the body to react to a stressful situation (for example, a situation of physical stress).
The response to extreme stress is often described as “fight or flight.” It was developed in the process of evolution and is a kind of defense mechanism, allowing you to react almost instantly to danger.
When a person finds himself in dangerous situation, his hypothalamus serves adrenal glands , where it is formed hormone adrenaline, a signal about the release of the latter in blood . The body’s reaction to such a release develops within a few seconds: a person’s strength and speed increase significantly, while sensitivity to pain sharply decreases.
Such a hormonal surge is usually called “adrenaline.”
By influencing localized tissues and liver β2-adrenergic receptors , hormone stimulates gluconeogenesis (biochemical process of formation glucose from inorganic precursors) and the process biosynthesis of glycogen from glucose (glycogenesis).
The effect of adrenaline when introduced into the body is associated with an effect on α- and β-adrenergic receptors and is in many ways similar to the effects that occur during reflex excitation of sympathetic nerve fibers.
The mechanism of action of the drug is due to the activation of the cyclic cyclic acid responsible for the synthesis AMP (cAMP) enzyme adenylate cyclase .
Adrenaline-sensitive receptors are located on outer surface cell membranes , that is hormone does not penetrate into the cell. Its effect is transmitted into the cell thanks to the so-called second messengers, the main one of which is cyclic AMP . The first intermediary in the regulatory signal transmission system is the hormone .
Symptoms of the release of adrenaline into the blood are:
- narrowing blood vessels in the skin ,mucous membranes , as well as in abdominal organs (at the same time, the vessels in the skeletal muscle tissue );
- dilation of blood vessels located in brain ;
- increase in frequency and strengthening of contractions heart muscle ;
- relief atrioventricular (atrioventricular) conduction ;
- increasing automation heart muscle ;
- increase in performance;
- transient reflex bradycardia ;
- relaxation smooth muscles of the bronchi and intestinal tract ;
- decline intraocular pressure ;
- dilated pupils ;
- decrease in output intraocular fluid ;
- hyperkalemia (with prolonged stimulation of β2-adrenergic receptors);
- increased concentration in free fatty acids .
When adrenaline is administered intravenously or subcutaneously, the drug is well absorbed. The maximum plasma concentration after injection under the skin or muscle is observed after 3-10 minutes.
Adrenaline is characterized by the ability to penetrate into placenta and in breast milk , while it is almost unable to penetrate through BBB (blood-brain barrier) .
Metabolization it is carried out with the participation enzymes monoamine oxidase (MAO) and catechol-O-methyltransephrase (COMT) in sympathetic nerve endings and internal organs . The resulting products are inactive.
T1/2 (half-life) after intravenous administration of epinephrine is approximately 1-2 minutes.
The drug is used with caution to treat elderly patients and children.
Side effects
Adrenaline provokes not only a significant increase physical strength, speed and productivity, but also quickens breathing and sharpens attention. It's not uncommon to throw this out hormone accompanied by a distortion of the perception of reality and.
In cases where the release hormone occurred, but there is no real danger, the person feels irritability and anxiety. The reason for this is that the release of adrenaline is accompanied by an increase in the production of glucose and increased blood sugar levels blood . That is, the human body receives additional energy, which, however, does not find a way out.
In the distant past, most stressful situations were resolved through physical activity, in the modern world, the amount of stress has increased significantly, but practically no physical activity. For this reason, many people exposed to stress actively engage in sports to reduce adrenaline levels.
Despite the fact that adrenaline plays a leading role in the survival of the body, over time it leads to negative consequences. So, a long-term increase in the level of this hormone inhibits activity heart muscle , and in some cases can even provoke heart failure .
Increased adrenaline levels are also the cause of frequent nervous disorders (nervous breakdowns ). Such symptoms indicate that a person is in a state of chronic stress.
The body's reaction to the administration of Adrenaline may include the following side effects:
- improved performance blood pressure ;
- increase in contraction frequency heart muscle ;
- violation heart rate ;
- painful sensations in the chest area hearts .
At arrhythmias , provoked by the administration of the drug, the patient is shown drugs pharmachologic effect which are aimed at blocking β-adrenergic receptors (for example, or ).
Instructions for use of Adrenaline
Adrenaline hydrochloride instructions for use recommend administering it subcutaneously to patients, less often - intravenously. muscle or in vein (slow drip method). The drug must not be administered into artery , since pronounced narrowing peripheral blood vessels may provoke development.
Depending on the features clinical picture and on the purpose for which the remedy is prescribed, single dose for an adult patient it varies from 0.2 to 1 ml, for a child - from 0.1 to 0.5 ml.
At acute cardiac arrest the patient should be administered intracardially the contents of one ampoule (1 ml); for ventricular fibrillation, a dose of 0.5 to 1 ml is indicated.
Monoamine oxidase inhibitor (MAO) drugs sympatholytic octadin , blocking agents m-cholinergic receptors , n-anticholinergics , drugs hormones thyroid gland potentiate pharmacological action epinephrine .
In its turn, epinephrine reduces efficiency hypoglycemic drugs (including insulin); neuroleptic , cholinomimetic And sleeping pills ; opoid , muscle relaxants .
When used concomitantly with drugs that prolong the QT interval (for example, astemizole or ), the effect of the latter is significantly enhanced (the duration of the QT interval increases accordingly).
It is not allowed to mix Adrenaline solution with solutions of acids, alkalis and oxidizing agents in one syringe due to the possibility of them entering into chemical interaction with epinephrine .
Terms of sale
The drug is intended for use in hospital settings and in emergency hospitals. Distributed through interhospital pharmacies. Dispensing is by prescription.
Recipe for Latin prescribed by a doctor, indicating the dose and method of administration.
Storage conditions
The drug is included in List B. It is recommended to store it in a cool place, out of reach of children. Freezing is not allowed. Optimal temperature regime— 12-15°C (if possible, it is recommended to place Adrenaline in the refrigerator).
A solution that has turned brown, as well as a solution containing sediment, is considered unsuitable for use.
Best before date
special instructions
How to reduce the level of adrenaline in the blood
Excess of adrenaline that produces chromaffin tissue of the adrenal glands , is expressed in emotions such as fear, rage, anger and indignation.
The hormone prepares a person for stressful situation and improves functional abilities skeletal muscle tissue , however, if it is produced in large doses over a long period of time, it can cause severe debilitation and death.
For this reason, it is very important to be able to control your adrenaline levels. Its reduction is largely facilitated by:
- regular strength training (classes in gym, morning jogging, swimming, etc.);
- conducting healthy image life;
- passive relaxation (attending a concert, watching a comedy, etc.);
- herbal medicine (decoctions of herbs that have a sedative effect are very effective: mint, lemon balm, sage, etc.);
- hobby;
- eating a large amount of vegetables and fruits, taking vitamins, eliminating strong drinks, caffeine, and green tea from the diet.
Some people are interested in the question “How to get adrenaline at home?” As a rule, in order to get a release of this hormone, it is enough to engage in some extreme sport (for example, mountaineering), go kayaking along the river, hiking or go roller skating.
Reviews about Adrenaline
It is quite difficult to find reviews about Adrenaline on the Internet; there are few of them. However, those that do occur are positive. Thanks to your pharmacological properties The drug is valued by doctors. Its use often allows not only to preserve health, but also to save the patient’s life.
Adrenaline price
The price of an Adrenaline ampoule in Ukraine is from 19.37 to 31.82 UAH. You can buy Adrenaline in a Russian pharmacy for an average of 60-65 rubles per ampoule.
PrJSC "Pharmaceutical Firm "Darnitsa", UkrainePaniPharmacy
Norepinephrine tartrate agetan 2 mg/ml 4 ml No. 10Ukraine, Laboratory Agetan
Ukraine, Health LLC
Adrenaline ampoule Adrenaline solution d/in. 0.18% amp. 1ml No. 10Ukraine, Darnitsa ChAO
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Recipe: Solutionis Adrenalini hydrochloridi 0.1% - 1 ml
D.t.d.N. 10 in ampullis
Signa. Subcutaneously 0.5 ml 1-2 times a day.
Adrenaline is a biogenic catecholamine. Contained in chromaffin cells of the adrenal medulla. Adrenaline has a direct stimulating effect on 7a 0-7 0 and 7b 0 adrenergic receptors, causing corresponding effects.
The effect of adrenaline on cardiovascular system. By stimulating 7b0-adrenergic receptors of the heart, adrenaline increases the strength and frequency of heart contractions and, in connection with this, systolic and cardiac output. At the same time, myocardial oxygen consumption sharply increases. Systolic blood pressure increases. The pressor reaction usually causes reflex bradycardia, but it is short-lived. General peripheral resistance may decrease, increase or remain unchanged. Most often, with the introduction of medium doses of adrenaline, a decrease in TPS is observed (manifested by a decrease in diastolic blood pressure), which is associated with the predominance of the effect of excitation of 7b 0-adrenergic receptors in the vessels of muscles and other areas and their expansion. However, mean arterial pressure increases due to an increase in systolic blood pressure. In high doses, adrenaline can also increase OPS. The pressor effect of adrenaline is usually replaced by a depressor effect, which is associated with the excitation of vascular 7b 42 0-adrenergic receptors. Adrenaline dilates the pupils of the eyes, reduces intraocular pressure. By stimulating 7b 42 0-adrenergic receptors of the bronchi, it relaxes smooth muscles and eliminates bronchospasm. Tone and motor skills gastrointestinal tract decreased under the influence of adrenaline. sphincters are toned.
Adrenaline potentiates neuromuscular transmission, apparently due to increased secretion acetylcholine from presynaptic endings, as well as the direct effect of adrenaline on the muscle.
Adrenaline stimulates glycogenolysis (hyperglycemia occurs, the content of lactic acid and potassium ions in the blood increases) and lipolysis (an increase in the content of free fatty acids in the blood plasma).
When adrenaline acts on the central nervous system, mild excitation effects predominate. Restlessness, tremor, stimulation of the vomiting center, etc. are noted.
Apply adrenaline for anaphylactic shock, allergic edema of the larynx, bronchial asthma and other allergic reactions, to increase blood pressure during shock and collapse, but selective 7a0-adrenergic agonists are preferable. Adrenaline is used to eliminate atrioventricular block, when sharp decline myocardial excitability during cardiac arrest. Used locally to constrict blood vessels during bleeding, added to local anesthetics. It is also used to dilate the pupil and treat open-angle glaucoma.
Side effects: tachycardia, increase cardiac output, sharp increase blood pressure, deterioration of oxygen supply to the myocardium, arrhythmias, pain in the heart area.
Adrenalin contraindicated for hypertension, severe atherosclerosis, aneurysms, thyrotoxicosis, diabetes mellitus, pregnancy. Adrenaline should not be used during anesthesia with fluorotane and cyclopropane.
Since adrenaline is destroyed when administered orally, it is used parenterally (subcutaneously, intramuscularly and intravenously) and locally, sometimes intracardiacly. Adrenaline has a short-term effect, as it is rapidly absorbed into neurons, as well as enzymatically destroyed.
Release form: ampoules of 1 ml of 0.1% solution; bottles of 10 ml of 0.1% solution. List B.
Aldactone(Aldactone). Synonym: spironolactonum.
In case of secondary aldosteronism When mineralocorticoids are secreted excessively, there is increased sodium absorption and fluid retention occurs in the body. In these cases good effect achieved through the use of aldactone and its analogues.
Indications: secondary aldosteronism, idiopathic edema, obesity and swelling in some hypothalamic-pituitary syndromes, hypothyroidism, cardiovascular failure with edema, nephropathy, hypertension.
Aldactone can be used in the period of preparation for aldosterone removal surgery for primary aldosteronism.
Upon appointment aldactone it is necessary to monitor the level of potassium and sodium in the blood.
At renal failure in some cases, the use of aldactone is contraindicated.
Recipe:
Rp. Aldactoni 0.025 g
D.t. d. N. 50 S. Orally, 1 tablet 2 times a day
Among the medicinal drugs To suppress the function of the adrenal cortex, medications such as amphenone and metopyrone were obtained. They block the synthesis of corticoid hormones, but have some toxicity.
Physiological role adrenaline and norepinephrine in the human and animal body has been well studied. Their effect on the central and peripheral nervous system, on sympathetic fibers has been experimentally confirmed.
Adrenalin helps increase blood pressure, determines heart rate, pulse rhythm, expands coronary vessels hearts. The sympathetic-adrenal system influences the function of the thyroid gland. Under the influence of adrenaline, the breathing rhythm increases, the lumens of the bronchi expand during spasms that occur during bronchial asthma. Adrenaline increases the breakdown of glycogen in the liver and increases blood sugar levels.
Actively participating in reactions stress, adrenaline stimulates the thyrsotropic and adrenocorticotropic functions of the pituitary gland.
To the group catecholamines include the substances norepinephrine and dopamine, which appear in the process of its synthesis.
Adrenaline hydrochloride (Adrenalinum hydrochloricum). Indications: acute cardiovascular failure, cardiac arrest, addisopic crisis, hypoglycemic state, drop in blood pressure, attacks of bronchial asthma. Causing spasm of peripheral vessels, it is used as a hemostatic agent.
Contraindications: diabetes mellitus, thyrotoxicosis, tumor of the adrenal medulla - pheochromocytoma. Severe atherosclerosis, cardiosclerosis, atrioventricular block. Pregnancy.
Recipe:
Rp. Solutio Adrenalini hydrochloric! 0.1% 1.0
D.t. d. N. 6 in ampul. S. 0.5-1 ml 1-2 times a day under the skin
Norepinephrine bitartrate (Noradrenalinum bitartaricum). Its effect is not more pronounced than the effect of adrenaline, but unlike it, it slows down the heart rate and increases systolic and diastolic pressure.
Indications: collaptoid states and cardiovascular failure.
Prophylactically for surgical removal pheochromocytomas.
Contraindications the same as when using adrenaline.
Recipe:
Rp. Sol. Noradrenalini 0.1% 1.0
D.t. d. N. 3 in ampul.
S. 1 ml of solution in 300 ml of 5% glucose solution, intravenous drip
Recipe (international)
Rp.: Sol. Epinephrini hydrochloridi 0.1% - 1 ml
D.t.d. N. 6 in ampullis.
S. inject 0.5 ml subcutaneously for anaphylactic shock
pharmachologic effect
Stimulates alpha and beta adrenergic receptors.
In terms of its peripheral sympathomimetic effect, ephedrine is close to adrenaline. Causes vasoconstriction, increased blood pressure, dilation of the bronchi, inhibition of intestinal peristalsis (wave-like movements), dilation of the pupils, increased blood glucose levels.
Compared to adrenaline, ephedrine has a less dramatic, but much longer-lasting effect. Due to its greater stability, ephedrine is effective when administered orally and is convenient for use during a course of treatment (for example, with allergic diseases).
Unlike adrenaline, ephedrine has a specific stimulating effect on the central nervous system. In this respect, it is close to phenamine, but the latter is much stronger.
Mode of application
For adults: Epinephrine is administered subcutaneously, intramuscularly, or intravenously.
For anaphylactic shock: slowly intravenously 0.1-0.25 mg diluted in 10 ml of 0.9% sodium chloride solution, if necessary, continue intravenous drip administration at a concentration of 0.1 m/ml; if the patient’s condition allows for a slow action (3-5 minutes), then it is preferable to administer 0.3-0.5 mg intramuscularly (or subcutaneously) in undiluted or diluted form; if necessary, the administration is repeated after 10-20 minutes (up to 3 times).
As a vasoconstrictor, it is administered intravenously at a rate of 1 mcg/min (with a possible increase in the rate of administration to 2-10 mcg/min).
For bronchial asthma: intravenously 0.1-0.25 mg diluted at a concentration of 0.1 mg/ml or subcutaneously 0.3-0.5 mg undiluted or diluted, repeated doses, if necessary, can be administered every 20 minutes (up to 3 times).
Asystole: intracardially 0.5 mg (diluted with 10 ml of 0.9% sodium chloride solution or other solution); when conducting resuscitation measures- 1 mg (diluted) intravenously every 3-5 minutes; if the patient is intubated, then endotracheal administration is possible - optimal doses have not been established, but should be 2-2.5 times higher than the dose for intravenous administration.
Prolongation of action local anesthetics: at a concentration of 5 mcg/ml (the dose depends on the type of anesthetic used), for spinal anesthesia- 0.2-0.4 mg.
Newborns (with asystole): intravenously, slowly, 10-30 mcg/kg every 3-5 minutes; children over 1 month: intravenously, 10 mcg/kg (later, if necessary, 100 mcg/kg is administered every 3-5 minutes); endotracheal administration may be used.
For children with bronchospasm: 10 mcg/kg subcutaneously (maximum - up to 0.3 mg), if necessary, the administration is repeated every 15 minutes (up to 3-4 times) or every 4 hours.
For children with anaphylactic shock: intramuscularly or subcutaneously - 10 mcg/kg (maximum - up to 0.3 mg), if necessary, repeat these doses every 15 minutes (up to 3 times).
Open-angle glaucoma - 2 times a day, 1 drop of 1-2% solution. To stop bleeding, locally, in the form of tampons that are moistened with a solution of the drug.
When performing an infusion, it is necessary to use a device with a measuring device to regulate the rate of drug administration. Infusions should be carried out in large vein(preferably in the central one). Intracardiac epinephrine is administered for asystole only if other methods are not available, as there is a risk of pneumothorax and cardiac tamponade. During epinephrine therapy, it is recommended to monitor serum K+ levels, measure diuresis, blood pressure, IOC, central venous pressure, ECG, pulmonary capillary wedge pressure and blood pressure. pulmonary artery.
High doses of epinephrine during myocardial infarction may increase ischemia due to increased myocardial oxygen demand. Epinephrine increases glycemia, so diabetes requires higher doses of sulfonylurea derivatives and insulin. When administered endotracheally, the absorption and final plasma levels of epinephrine may be unpredictable.
Epinephrine can be used in children for cardiac arrest, but caution must be used as the dosing regimen requires 2 different concentrations of the drug. When discontinuing therapy, doses should be reduced gradually, since sudden discontinuation of treatment may cause severe hypotension.
Indications
for elimination allergic reactions immediate type (Quincke's edema, anaphylactic shock, urticaria), which developed as a result drug allergies, during blood transfusion, consumption food products, introduction of other allergens or insect bites;
With asystole, including against the background of 3rd degree AV block;
- relief of an attack of bronchial asthma;
- bronchospasm that occurs during the use of anesthesia;
- prolongation of the effect of local anesthetics;
- arterial hypotension that cannot be treated with replacement fluids (after injuries, in in a state of shock, with bacteremia, operations on open heart, in case of renal failure, drug overdose, heart failure);
- hypoglycemia caused by an overdose of insulin;
- glaucoma, if required surgical intervention on the eyes, in order to dilate the pupil, relieve intraocular pressure;
- stopping bleeding;
- treatment of priapism.
Contraindications
Hypersensitivity, pheochromocytoma, HOCM, arterial hypertension, ischemic disease heart, ventricular fibrillation, tachyarrhythmia, lactation, pregnancy.
Side effects
angina pectoris, tachycardia, palpitations, bradycardia, increased or decreased blood pressure;
ventricular arrhythmia, chest pain, cardiac
arrhythmia (high dosages of the drug);
anxiety, tremor, headaches, dizziness;
less often than usual - feeling tired, feeling hot or cold, nervousness;
insomnia, spontaneous muscle contractions, nervous system excitement, memory loss, disorientation, panic and aggression, paranoia, disorders similar to schizophrenia (rare);
vomiting, problems with urination, pain during urination, nausea;
allergic skin rashes, bronchospasm, Quincke's edema, erythema multiforme;
sweating, hypokalemia - rare;
cramps, persistent and strong erection, muscle tightening.
During intramuscular injection Pain and burning may occur at the injection site.
Release form
Powder; tablets 0.002; 0.003 and 0.001 g (for pediatric practice);
5% solution (for injection) in ampoules of 1 ml;
2% and 3% solutions in 10 ml bottles (for otorhinolaryngological practice).
ATTENTION!
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