Adrenaline is a hormone and neurotransmitter secreted by the adrenal medulla. It acts on alpha and beta adrenergic receptors to trigger the body's fight or flight response, increasing blood pressure, heart rate, and blood flow to muscles. Adrenaline is administered via subcutaneous or intramuscular injection to treat anaphylaxis, cardiac arrest, severe asthma, and nosebleeds. It can cause side effects like hypertension, arrhythmias, and anxiety if given improperly.

1. PATIENT PROFILE & PATIENT COUNSELING
C. DRUG PROFILE OF ATLEAST 25 IMPORTANT
MEDICATIONS
ADRENALINE
CLINICAL PHARMACY
BY
Zul Kamal
DEPARTMENT OF PHARMACY
SHAHEED BENAZIR BHUTTO UNIVERSITY,
SHERINGAL

2. C. DRUG PROFILE OF ATLEAST 25 IMPORTANT MEDICATIONS
NERVOUS SYSTEM
With neurotransmitters
norepinephrine and
acetylcholine
*Either “fight and flight”
mode or “rest and
digest”
Includes neurons and
ganglia outside of the
brain and spinal cord
Peripheral
Nervous
System
*Autonomic
Nervous System
(involuntary)
Sympathetic
Nervous System
(adrenergic)
Parasympathetic
Nervous System
(cholinergic)
Somatic Nervous
System
(voluntary)

3. SYMPATHETIC NERVOUS SYSTEM
Fight or flight response results in:
1. Increased BP
2. Increased blood flow to brain, heart and skeletal muscles
3. Increased muscle glycogen for energy
4. Increased rate of coagulation
5. Pupil dilation

4. ADRENERGIC RECEPTORS
• Alpha—A1 and A2
• Beta—B1, B2, B3
• Dopamine—subsets D1-5

5. REVIEW OF FUNCTIONS OF SYMPATHETIC NERVOUS SYSTEM RECEPTORS
• Alpha 1—smooth muscle contraction
• Alpha 2-negative feedback causes less norepinephrine to be
released so BP is reduced
• Beta 1—increased heart rate
• Beta 2—bronchodilation
• Beta 3—actual site for lipolysis

6. MECHANISMS OF ACTION AND EFFECTS OF ADRENERGIC DRUGS …1
• Direct adrenergic drug action
• Affects postsynaptic alpha 1 and beta receptors on target
effector organs
• Examples: epinephrine, Isuprel, norepinephrine,
phenylephrine

7. MECHANISMS OF ACTION CONT.2
2. Indirect adrenergic drug action occurs by stimulation of
postsynaptic alpha 1, beta 1 and beta 2 receptors.Cause
release of norepinephrine into the synapse of nerve endings or
prevent reuptake of norepinephrine.
• Examples include cocaine and TCAs

8. MECHANISMS OF ACTION CONT. 3
• 3. mixed action. Combination of direct and indirect receptor
stimulation
• Examples are ephedrine and pseudoephedrine

9. ADRENALINE
Secreted from Adrenal Adrenal Medulla (Adrenal Gland).
Sympathomimetic drug

10. What is Adrenaline (C9H13NO3) ?
• Catecholamine
– belongs to the family of biogenic amines
• A hormone and a neurotransmitter
• Enzymes responsible for fast degradation of
Adrenaline
1. Catecholamine-O-methyltransferase (COMT)
2. Monoaminoxidase (MAO)

11. Adrenaline as an Internal Drug
Effects of the Adrenal Gland
• Hyperarousal
• Increased blood flow
• Heightened pulse rate
• Increased physical
performance

12. Brain During Stress
Subcortical Fight or Flight Areas
• Subcortical Fight or Flight
areas includes thalamus,
hippocampus, brainstem,
and hypothalamus
• Mobilize body for action
• Bypass frontal executive
functioning and trigger
stress response

13. ADRENALINE
ADMINISTRATION
 S/C and I/M
 Orally doesn’t absorbed
 NOTE: If given I/V it causes hypertensive crises and causes
cerebral hemorrhages.
METABOLISES
 Metabolized in liver by the process of conjugation and
sulfation.
 Metabolized by MAO and COMT.
 Monoamine catecholeamine transferase
 Catechol-O-methyl transferase

14. ADRENALINE
EXCRETION
 Excreted as Vinyl Mandelic Acid (VMA).
MECHANISM
 Acts on adrenergic receptor (α and β), coupled by G-Protein
Coupled receptor.
INDICATIONS
 Anaphylactic shock
 Cardiac arrest
 Status asthmaticus (severe asthma)
 Epitaxis (bleeding from nose)
 Along with local anesthetic, it incresesea the duration of
action of local anesthetic.

15. ADRENALINE
CONTRAINDICATIONS
 Hypertensive patients
 Ischemic heart diseases (because adrenaline will increase
myocontractility and heart rate and oxygen demand which
may lead to worsen the condition)
 Anxiety (because it result in heart diseases)
 Hyperthyrodism (because it stimulate the sympathetic
nervous system, adrenaline will further increase it which will
cause harm to organ).

16. ADRENALINE
SIDE EFFECTS
 CVS: Hypertension, cardiac arrythmia (palpitation) and
angina.
 CNS: Anxiety, fear and tremors.
DOSAGE FORM
Injection and Aerosol
DOSES:
Bronchoconstriction: 0.4 mL soln diluted in 1:1000 SC
320 µg per puff in the form of aerosol.
Anaphylactic Shock: 3-0.5mL SC in soln 1:1000
Local Anesthetic: 0.5 mL IM diluted to 1:80000 1: 20000