Adrenalin injection solution 1mg/1ml of cardiac resuscitation, anaphylaxis emergency (5 blisters x 10 tubes)
Dosage form Box of 5 blisters x 10 tubes
Specifications Adrenaline
Ingredient Anaphylaxis, heart failure
Ingredient
| Composition information | Content |
| Adrenaline | 1mg/ml |
Uses
indications
Adrennalin is indicated in the following cases:
On the heart - vessels, adrenalin works to increase frequency and increase myocardial muscle tightening force; Increasing the volume of systolic and oxygen consumption of the heart muscle, increasing coronary flow, increasing peripheral resistance causing systolic hypertension.
When intravenously transmitted, peripheral resistance and diastolic blood pressure, at first the heart frequency increased, but then decreased due to sympathetic reflexes. Plasma volume decreases due to non -protein epidemic entry into extracellular areas.
Adrenalin increases platelet's adhesion and increases blood clotting.
On the respiratory apparatus, Adrenalin stimulates mild respiration, causing strong bronchodilions, but makes the bronchial fluid more smooth.
On the central nervous system, although Adrenalin is less absorbed, it still has a stimulating effect, the drug has little effect on the circulatory flow.
On the digestive system, the drug causes tone reduction and secretion of the intestine, increases the blood flow.
On the urinary - genital system, Adrenalin sharply reduces the blood flow (can be up to 40%), but the filtration level of the glomerular is less changing; Reducing bladder tone, but increasing smooth muscle tone, which can lead to difficulty.
Adrenalin inhibits pregnant uterine contractions.
On metabolic, adrenalin causes insulin secretion, glucagon secretion and glycogen resolution speed, leading to hyperglycemia; Increasing the activity of renin, increasing the concentration of free fatty acids and potassium in plasma. Adrenalin can cause basic metabolism 20 - 30% and together with skin vessels, can cause fever.
Pharmacokinetics
absorption
The drug has a quick effect when intramuscularly or subcutaneously (the subcutaneous line is slower than intramuscular).
Metabolism
Whether it is injected or caused by the adrenal marrow, most adrenalin in the circulation are inactivated very quickly due to being imported into nerve cells, diffusion and liver and tissue resolved enzymes. Catechol enzyme - 0 - methyltransferase (comt) inactivating external Adrenalin and endogenous adrenalin, while mono amino oxydase enzymes (Mao) are mainly inactive catecholamin in the central nervous system.
Elimination
Metabolic products are excreted in urine in the form of no activity, some are output in the form of intact or combined.
Before taking Adrenalin injection solution 1mg/1ml of cardiac resuscitation, anaphylaxis emergency (5 blisters x 10 tubes)
How to use
Adrenalin injection solution can be used for intramuscular injection, intravenous injection, intravenous injection, gloomy injection, subcutaneous injection. Injecting subcutaneously often absorbed more slowly and less effectively.
Intramuscularly: avoid injecting into the buttocks, should be injected into the outer area of the thigh in case of anaphylaxis.
Absolutely prohibited adrenalin injected into veins.
There is no special requirement on drug treatment after use.
Dosage
The dosage must be calculated according to the severity and the response of each patient.
Anaphylaxis
Adrenalin is a priority medication for treating anaphylaxis. The initial dose should be used in adults is subcutaneous injection or intramuscularly from 0.3 to 0.5 ml of 1/1000 solution (1 mg/ml), every 20 or 30 minutes of injection once.
If intramuscularly or subcutaneous injection is not effective, it is necessary to use intravenous sugar; Intravenous dose is from 3 to 5 ml of 1/10000 concentration solution (diluted with 0.9% sodium chloride solution or isotonic glucose); The times separated from 5 to 10 minutes. If the cardiovascular collapse is severe, admingins must be injected directly into the heart. In the case of shock, severe shortness of breath or when obstructing in the respiratory tract, veins should be used.
cardiac arrest
Adrenalin is a priority medication to treat cardiac arrest. The commonly recommended dose is intravenous from 0.5 to 1 mg, separated from 3 to 5 minutes. For people who have suffered from cardiac arrest before being hospitalized, sometimes they have to take a much higher dosage (up to 5 mg of intravenous injection). Continuous adrenalin can be transmitted (0.2 to 0.6 mg/min), if necessary. It is also possible to be injected directly into the heart 0.1 - 1.0 mg adrenalin mixed in several ml of 0.9% sodium chloride solution or isotonic glucose solution.
Inject adrenalin into a vein, into the trachea or in the heart that works well in treating cardiac arrest due to ventricular vibration. Adrenalin is mainly used in the case of ventricular vibration treatment with electrical shock failure. The recommended dose in children is 7 - 27 micrograms/kg (average is 10 micrograms/kg).
Infectious shock
In the case of severe infection treatment by infection, dopamine transmission alone or in combination with dobutamin fails, adrenalin transfers into veins (0.5 to 1 microgram/kg/minute) may have good results.
Severe bronchial asthma attack
Adrenalin is a drug that can be used to treat acute asthma attacks, because the drug has a quick effect and reduces bronchial edema, so it contributes to improving living capacity. Adrenalin injected subcutaneously usually works immediately, but because of the short effect, every 20 minutes must be injected again.
Adrenalin doses subcutaneously can maintain the effect of the first injection without causing the accumulation of the drug. The dose of 0.5 mg of adrenalin subcutaneously is considered the optimal dose to treat acute acute asthma attacks, but the at least impact on the heart -circuit system. Do not consider hypertension and fast heart to be contraindicated for using this dose adrenalin, if the patient does not have hypertension or heart disease before.
Wheeze in young children
Adrenalin injected subcutaneously has a good effect to regulate shortness of breath in children under 2 years old. Adrenalin (1 mg/1 ml) is injected at a dose of 0.01 ml/kg.
Gastrointestinal bleeding on
Endoscopic adrenalin injection has a good effect to treat bleeding ulcers in patients with gastrointestinal bleeding. Inject 0.5 ml of adrenalin solution (1/10,000) divided into multiple nose in the middle and around the bleeding site until the blood stops.
Pain relief in obstetricians
Adrenalin is often added to local anesthetic to increase pain relief or to enhance and prolong epidural anesthesia. Add 0.2 mg of Adrenalin to an anesthetic mixture with 10 micrograms of Sufentanil and 2.5 mg of bupivacaine that extends pain relief during delivery without causing clinical side effects for both fetus and mother. Add adrenalin to the mixture of Sufentanil and Bupivacaine significantly extending the numbness and reduces the sensation without affecting movement.
local anesthesia
Combine adrenalin with local anesthetic solutions (such as tetracaine/adrenalin/cocaine or tetracaine/lidocaine/adrenalin) has good pain relief in some minor surgery (stitches of non -infections or complexity in the face and scalp) in children).
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose? Immediately injecting the drug has the effect of alpha blockers (phentolamin), then injected the drug with beta blockers (propranolol) to combat the effect of adrenalin's vasodilation and arrhythmia. Glyceryl trinitrate can be used.
What to do when forgetting 1 dose?
Side Effects
When using adrennalin, you may experience unwanted effects (ADR).
Common, ADR> 1/100
Uncommon, 1/1000 Urinary - genital: difficulty, urination. Rare, 1/10000 Neurological: confusion, mental disorders, cerebral hemorrhage. Instructions on how to handle ADR Inadvertently injected into the toes, fingers, feet, hands that can cause local reactions such as cyanosis, cold, loss of sensation, bruising, bleeding, red rash, bone damage. If the above signs occur, the doctor should immediately go to the doctor. It is necessary to stop the drug and consult a physician when there are signs such as increased sensitivity or if the discomfort appears and increases during the use of the drug during surgery. Handling when the drug is escaped into blood vessels: using phentolamine as an antidote. Mix 5 mg phentolamine with 9 ml of 0.9%sodium chloride solution, inject a small amount of this mixture into the exit area. The pale place will end immediately. Track that area. If the phenomenon is pale, there may be an additional phentolamine. While using drugs, lung function, heart rate, blood pressure, pale level in the transmission position, vascular escape phenomenon. In the process of continuous drug transmission, heart and blood pressure monitoring. If used to treat hypotension, need to evaluate the volume of the circuit. When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
contraindicated
Adrenalin contraindicated drug in the following cases:
Patients with anesthesia with cyclopropan, Halothan or Halothan group anesthesia because they can cause ventricular vibration.
Patients with severe cardiovascular disease, people with myocardial dilatation, coronary insufficiency.
Be cautious when used
absolutely prohibited adrenalin injection has not been diluted into the vein. In patients who are too sensitive to Adrenalin, especially people with hyperthyroidism.
In patients with cardiovascular disease (myocardial ischemia, arrhythmia or tachycardia, obstruction of blood vessels (atherosclerosis, hypertension, aneurysm).
Patients with diabetes.
Patients are using cardiac glycosides, quinidine, antidepressants.
Inadvertently inject Adrenalin into the fingers, toes, hands, feet that can cause local reactions such as cyanosis, cold, loss of sensation, bruising, red rash, bleeding, bone damage. If the above signs occur, the doctor should immediately go to the doctor.
Fast intravenous injection can be fatal due to cerebral hemorrhage or arrhythmia, but in case of cardiac arrest, fast intravenous injection.
In the adrenalin injection contains sodium metabisulfit. This substance can cause allergic reactions that include overheating symptoms such as bronchospasm and anaphylactic shock, especially people with bronchial asthma. Therefore, be cautious when taking drugs in these patients.
The ability to drive and operate machinery
The drug can cause unwanted effects such as headache, fatigue, fast heart rate, hypertension ... Therefore, do not drive or operate machinery when experiencing unwanted effects of the drug.
pregnancy
adrenalin passes through the placenta and in the cycle of the fetus in very small amounts. It is not thought that it has the effect of causing fetal deformities in humans.
Test on mice shows Adrenalin at a dose of 25 times the dose on human can cause teratogenic.
Use Adrenalin in the last months of pregnancy or during birth may cause an oxygen deficiency for the fetus.
should only use Adrenalin for pregnant women when the benefits are exceeded the risks that may occur for the fetus.
The period of breastfeeding
It is not known whether the drug is in breast milk or not, but the drug is often in breast milk, so be careful not to breastfeed.
Drug interactions
Parcounter and oxytocin: Should not be used with adrenalin because it has the ability to increase the side effects and toxicity of these drugs.
Alpha adrenergic blockers like phentolamine: Antibiotic with vascular shrinkage and hypertension of adrenalin.
Medicines for hypertension: Adrenalin increases blood pressure, so it can disable the effects of antihypertensive drugs when used in combination.
Other drugs: Adrenalin should not be used in patients who receive high doses of other drugs (such as cardiac glycosides) due to can cause an increase in arrhythmia. Some antihistamines (such as diphendramine) and stimulating thyroid hormones can increase adrenalin side effects, especially on heart rate.
Medicines that reduce blood potassium include corticosteroids, diuretics, potassium, aminophylin and theophylin: When combined with adrenalin can cause excessive hypotension syndrome.
Diabetes treatment: Coordination with adrenalin can lead to loss of blood sugar control in diabetics treated with insulin or oral hypoglycemic drugs.
Beta blockers: Adrenalin's hypertension effects significantly increased in patients using unsatisfactory beta blockers like propranolol. There may be significant hypertension reactions and/or slow heart rate, life -threatening. Do not use unsatisfactory beta inhibitors (such as propranolol) for people with asthma, because it can cause bronchospasm.
Mono Amino Oxydase inhibitors (Mao): Adrenalin's hypertension effect may not change or only change less in patients with Mao inhibitors.
Anesthesia: Patients with anesthesia by volatile anesthesia (cyclopropan, enfluran, halothan, isofluran, fluoroxen, methoxyfluran, diethyl ether) are at risk of arrhythmia if using adrenalin, unless very small doses. Adrenalin dose must not exceed 1 microgram/kg/30 minutes if there is Halothan; Do not exceed 3 micrograms/kg/30 minutes if used Enfluran or Isofluran to prevent ventricular arrhythmia. Children less.
alkaloids of Vayowolfia: When there are alkaloids of Vayowolfia, the hypertension effect of Adrenalin vapor increases.
Triple -round antidepressants: Patients treated with three -round antidepressants have a very strong response to adrenalin injection (hypertension, arrhythmia ...). Even on -site anesthesia with adrenalin should not be used for these patients.
Ma Hoang, Yohimbin: Avoid using simultaneously because it can cause central nervous irritation.
Adrenalin is similar to alkaline solutions (such as sodium bicarbonate).
Storage
In a dry place, temperatures below 30 ° C, avoid light.
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