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treatment_adrenaline [2025/04/16 03:23] – [2.3 Indication 3] jkohtstreatment_adrenaline [2025/04/29 02:21] (current) – [7. References] jkohts
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 ===== - Cautions & Contraindications ===== ===== - Cautions & Contraindications =====
 +There are no absolute contraindications to the use of adrenaline in a life-threatening situation. 
 +  * Overtreatment may result in hypertension and tachyarrhythmias. 
 +  * ↑ serum lactate. 
 +  * Myocardial ischemia.
  
 ===== - Special Populations ===== ===== - Special Populations =====
-**Pregnancy rating:** +**Pregnancy rating:** A (AU/NZ)
- +
-**Lactation:** +
- +
-**Renal impairment:** +
- +
-**Hepatic impairment:**+
  
 +**Lactation:** Excreted in breast milk, but potential effects on breastfed infant is unknown.
  
 ===== - Adverse Effects ===== ===== - Adverse Effects =====
-  * Description of important/serious adverse effects, e.g. +  * **CVS:** hypertension, tachyarrhythmias, myocardial ischemia. 
-  * Serotonin syndrome:  +  * **CNS:** anxiety, tremor. 
-  * Systems e.g.  +  * **Skin:** tissue necrosis if extravasates. 
-  * **GI:** +  * **Metabolic:** hyperglycemia, hyperlactatemia.
-  * **Resp:** +
-  * **MSK:** local phlebitis +
-  * Frequency e.g. +
-  * **Common:** +
  
 ===== - Pharmacology ===== ===== - Pharmacology =====
  
 ==== - Pharmacodynamics ==== ==== - Pharmacodynamics ====
-**Mechanism of action:**+**Mechanism of action:** Dose-dependent adrenoceptor activity, with β-agonist effects predominate at low doses, and added α-agonist effects at higher doses.
  
 ==== - Pharmacokinetics ==== ==== - Pharmacokinetics ====
  
 **Absorption:** **Absorption:**
-  * Oral bioavailability: +  * Oral bioavailability: 0%.
-  * GI tract absorption: +
-  * First pass metabolism:+
  
 **Distribution:** **Distribution:**
-  * Vd:+  * Vd: 0.1-0.2 L/kg.
   * Lipid solubility:   * Lipid solubility:
-    * Crosses/Does not cross BBB +    * Does not cross BBB 
-    * Crosses/Does not cross placenta +    * Crosses placenta 
-    * Excreted/Not excreted in breast milk +    * Excreted in breast milk 
-  * Protein binding: +  * Protein binding: 50%
-  * Tmax:+
  
-**Metabolism:**+ 
 +**Metabolism:** Rapidly metabolized by COMT and MAO into metanephrine and 3,4-dihydroxymandelic acid, then ultimately into vanillylmandelic acid.
  
 **Excretion:** **Excretion:**
-  * Elimination t½: +  * Elimination t½: 2-3 mins. 
-  * Hepatic clearance: +  * Renal clearance: Renally excreted, mostly as inactive metabolites.
-  * Renal clearance:+
  
 ==== - Pharmaceutics ==== ==== - Pharmaceutics ====
 **Formulation:** **Formulation:**
- +  * Ampoules containing 1000 microgram/1 mL or 1000 microgram/10 mL. 
 +  * Autoinjector with varying doses (commonly 0.15 mg, 0.3 mg, 0.5 mg). Various brands exist, e.g. EpiPen, Emerade, Auvi-Q.
 ===== - References ===== ===== - References =====
-Useful general references:+Further Reading:
  
 ~~REFNOTES~~ ~~REFNOTES~~