Adrenaline

Adrenaline/Anapen, Epipen                 preg Risk A Dont need to know this.

Classifications: adrenergic agonist(non specific)

Action: treatment of hypotensive states, eg shock, bronchospasm, asthma; hypersensitivity reactions, anaphylaxis

Adverse reactions: arrythmias; shock, tachycardia, anginal pain, hypertension, palpitations; angina and dyspnoea; nausea, vomiting and constipation( depressant effects on GI), headache, sweating, feelings of tension, anxiety, piloerection.

Contraindications:hypersensitivity

Care considerations:hypersensitivity, phaeochromocytoma, tachyarrhythmias or ventricular fibrillation, general anesthesia with halogenated hydrocarbon anaesthetics, presence of vascular disease,
psychoneurosis,current status of pregnancy and lactation. use cautiously in individuals with shock(ie not anaphylaxis), with long standing bronchial asthma and emphysema.
Increases rigidity in Parkinsons disease.
Establish baseline-perform a physical assessment.
Assess vital signs, esp pulse and bp, monitor rr, auscultate lungs for adventitious sounds, to evaluate effects on bronchi and respiration, monitor urine output
Alerts:
* Avoid IM injection into buttocks(risk of gangrene), massage site after injection to counteract vasoconstriction
* Autoinjector: IM into the anterolateral aspect of thigh. Other sites not suitable. seek advice.
* Monitor person closely.
* If sharp increase BP give nitrites or alpha blockers to encourage vasodilation
* Alters blood glucose

Drug-drug:
alpha blockers results in hypotension from unopposed beta adrenergic effects;antihistamines, thyroid hormones; beta blockers causes vasoconstriction and reflex bradycardia; tricyclic antidepressants, MOAIs; increased risk of hypertension if given with herbal therapies and OTC preps. Any adrenergic agonist will lose effectiveness when combined with any adrenergic antagonist; General anesthesia with halogenated hydrocarbon; Levodopa, Guanethidine, Ergot alkaloids.

Dose: autoinjector: 0.15mg/mL to 0.5 mg/mL  MDI: 220mcg/dose

Teach people to avoid ma huang, guarana, caffeine due to increased risk of overstimulation( high bp, stroke and death)

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