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Epinephrine

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Epinephrine

  1. 1. Epinephrine / Adrenaline • By Shamin Joshi
  2. 2. Its primarily a medication as well as hormone Its an emergency drug Its direct sympathomimetics drugs Its 1st line drug used incardiac arrest At low dose , beta effect (vasodilators ) on vascular system predominant At high dose , alpha effect ( vasoconstrictor ) are strongest
  3. 3. Chemical Structure • molecular weight = 183.2. • Epinephrine solution deteriorates rapidly • On exposure to air or light, turning pink from oxidation to adrenochrome and brown from the formation of melanin.
  4. 4. Routes • IV • Intratracheal • Continous infusion • nebulisation
  5. 5. Metabolism • Epinephrine is rapidly inactivated in the body and is degraded by enzymes in the liver and other tissues. • The larger portion of injected doses is excreted in the urine as inactivated compounds and the remainder either partly unchanged or conjugated. • The drug becomes fixed in the tissues and is inactivated chiefly by enzymatic transformation to metanephrine or normetanephrine either of which is subsequently conjugated and excreted in the urine in the form of sulfates and glucuronides.
  6. 6. OrganEffects • Heart - Increases heart rate • Lungs - Increases respiratory rate • Systemic- Vasoconstriction and vasodilation • Liver - Stimulates glycogenolysis • Systemic - Triggers lipolysis • Systemic - Muscle contraction
  7. 7. Indication • Anaphylactic shock • Prolonged action of LA • Cardiac arrest • Bronchospasm • Chronic orthostatic hypotension • Topically , to stop bleeding • Minimal dysfunction of brain
  8. 8. Dose • La without adrenaline is 300mg or 4.4 mg/kg • With adrenaline is 500mg or 7mg/kg • Epineprine dilution of 1: 50000and 1: 100000 are considerably more effective
  9. 9. Epinephrine in lA Advantage • Prolongs duration of action of la by keeping them in contact with nerve fibers • Limits systemic absorption • Decreasing possibility of systemic toxicity cause rate of metabolism will match rate of absorption • Decreases bleeding ( improves visualization ) Disadvantage • Makes injection more painful • Increase chances of local injury and necrosis • May raise blood pressure and promote arrhymias
  10. 10. ADR • Stinging • Alergic lid rxn • Systemic hypertension • Arrythmia • Throbbing headache , • Tremor • Palpitation • Teratogenic effects
  11. 11. Contraindication • Severe hypertension • Cardiac disease • Thyrotoxicosis

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