International generic name

Epinephrine

Drug form and composition

Solution for injection. One ampoule of 1 ml contains 1mg Epinephrine (1 mg/ml).

Indications

Adrenalin is used in cases of anaphylactic shock, cardiac arrest, and resistant ventricular fibrillation.

Dosage and administration

Dosage should be defined according to the severity of the disease state. Adults: In case of anaphylactic shock adrenalin can be injected subcutaneous or intravenously using doses of 0.2 - 0.5 mg, maximally - up to 1 mg. In cardiac arrest adrenalin is used intravenously - doses of 0.5 - 1 mg given every 3 to 5 minutes during resuscitation. Children: Adrenalin is used intravenously in a dose of 0.01 mg/kg body mass during resuscitation.

Contraindications

Adrenalin is contraindicated in: pheochromocytoma, tachyarrhythmias, ventricular fibrillations, and idiopathic hypertrophic subaortic stenosis.

Special warnings and precautions

Adrenalin should be used with caution in the elderly, in individuals suffering from hyperthyroidism and severe heart diseases, in pregnant and breast-feeding women. It should be used with increased caution in following conditions: metabolic acidosis, atrial fibrillation, glaucoma, pulmonary hypertension, myocardial infarction, and occlusive vascular diseases.

Drug interactions

Adrenalin attenuates insulin activity. When used concurrently with cyclopropane, halothane, isoprenaline, there is a possibility of occurrence of cardiac rhythm disorders. Thiazide diuretics and phenothiazines induce a decrease in adrenalin activity, and thyroid hormones increase this activity. The application together with imipramine group antidepressants and MAO inhibitors can induce hypertensive crises with rhythm disorders. The combination with beta-blockers may lead to bradicardia, and the combination with -receptore blocking agents may result in fall of blood pressure.

Adverse reactions

The following adverse reactions are possible: palpitations, tremor, pallor, sweating, and difficulties during urination, nausea, vomiting, headache, ventricular arrhythmias, chest pain, hypertension, dispnea, hyperglycemia and hypokalemia.

Pharmacological mechanisms

Adrenalin is an - and -adrenergic receptor agonist representing the effects of the sympathetic influence on the organs. As a -receptor agonist, adrenalin increases the tone of the smooth muscle cells of blood vessels and induces constriction of the vessels in the abdominal cavity, skin and mucosae. Adrenalin induces a sharp, but brief, raise in blood pressure and stimulates the brain respiratory center. As an agonist of the -adrenergic receptors, adrenalin stimulates the contractility and excitability of myocardium, relaxes bronchial muscle cells, and induces glycogenolysis in the muscles and also lipolysis.

Supplied

10 or 100 ampoules of 1 ml (1 mg).

Expiry

2 years.