Adrenaline(1)

Medication used in critical emergency

1. Stimulates α and β adrenoceptors At low doses adrenaline has predominantly β adrenoceptor actions. ADRENALINE

2. Improves myocardial contractility (positive inotropic effect) as a result of increased influx of calcium into cardiac fibres. Increases cardiac rate (positive chronotropic effect Improve atrio -ventricular conduction (positive dromotropic effect). ADRENALINE

3. In low doses adrenaline decreases total peripheral vascular resistance and lower blood pressure In large doses Adrenaline activates α receptors in the peripheral vascular system which increases resistance and raises blood pressure. Net response is often vasodilation Bronchodilation Inhibits insulin secretion and decreases the uptake of glucose by peripheral tissues, thus raising blood glucose level. ADRENALINE

4. β -blockers such as proponolol , atenolol, bisoprolol , metoprolol etc. Entacapone Digitalis glycosides Halogenated anaesthetics such as halothane, enflurane , isoflurane Tricyclic antidepressants Oxytocics ADRENALINE Drug interactions

5. Nervousness, restlessness, insomnia, tachycardia, tremors, sweating, hypertension, nausea, vomitting , pallor and weakness. Entacapone Digitalis glycosides Halogenated anaesthetics such as halothane, enflurane , isoflurane Tricyclic antidepressants, monoamine oxidase inhibitors antidepressants, cocaine Oxytocics Adverse reactions

6. Diabetes mellitus Closed angle-glaucoma Hypertension Ischaemic heart disease Hyperthyroidism Parkinson’s disease Contraindications

7. Knights, K & Kathleen, B 2011, Pharmacology for health professionals , Chapter 12, Elsevier, Chatswood, Australia. REFERENCE