Adrenaline solution 0.1%, 1 ml No. 5
Expiration Date: 05/2027
Russian Pharmacy name:
Адреналин раствор 0,1%, 1 мл №5
Allergic reactions of immediate type (including urticaria, angioedema, anaphylactic shock) that develop with the use of drugs, serums, blood transfusions, food consumption, insect bites or the introduction of other allergens.
Bronchial asthma (relief of an attack), bronchospasm during anesthesia.
Asystole (including against the background of acutely developed third-degree AV block).
Bleeding from the superficial vessels of the skin and mucous membranes (including from the gums).
Arterial hypotension that does not respond to adequate volumes of replacement fluids (including shock, trauma, bacteremia, open heart surgery, renal failure, chronic heart failure, drug overdose).
The need to lengthen the action of local anesthetics.
Hypoglycemia (due to insulin overdose).
Open-angle glaucoma, during eye surgery - conjunctival edema (treatment), for pupil dilation, intraocular hypertension.
In order to stop bleeding.
Priapism treatment.
The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen.
Individual. Enter s / c, less often - i / m or i / v (slowly). Depending on the clinical situation, a single dose for adults can range from 200 ?g to 1 mg; for children - 100-500 mcg. The solution for injection can be used as eye drops.
Topically used to stop bleeding - use tampons moistened with epinephrine solution.
1 ml of solution for injection or for topical use contains 1 mg epinephrine hydrochloride ;
in a package of 5 ampoules of 1 ml or 1 bottle of 30 ml, respectively.
Hypertrophic obstructive cardiomyopathy,
pheochromocytoma,
arterial hypertension,
tachyarrhythmia,
Ischemic heart disease,
ventricular fibrillation,
pregnancy,
lactation period,
hypersensitivity to epinephrine.
Clinical and pharmacological group: Alpha-, beta-adrenergic agonist
Pharmaco-therapeutic group: Alpha and beta adrenomimetic
pharmachologic effect
Adrenomimetic, has a direct stimulating effect on? - and? -Adrenergic receptors.
Under the action of epinephrine (adrenaline), due to the stimulation of ?-adrenergic receptors, there is an increase in the content of intracellular calcium in smooth muscles. Activation of ? 1-adrenergic receptors increases the activity of phospholipase C (through stimulation of the G-protein) and the formation of inositol triphosphate and diacylglycerol. This promotes the release of calcium from the depot of the sarcoplasmic reticulum. Activation of ?2-adrenergic receptors leads to the opening of calcium channels and an increase in calcium entry into cells.
Stimulation of ?-adrenergic receptors causes G-protein-mediated activation of adenylate cyclase and an increase in cAMP production. This process is the trigger for the development of reactions from various target organs. As a result of stimulation of ? 1-adrenergic receptors in the tissues of the heart, an increase in intracellular calcium occurs. When ?2-adrenergic receptors are stimulated, there is a decrease in free intracellular calcium in smooth muscles, due, on the one hand, to an increase in its transport from the cell, and, on the other hand, to its accumulation in the depot of the sarcoplasmic reticulum.
Has a pronounced effect on the cardiovascular system. Increases heart rate and strength, stroke and cardiac output. Improves AV conductivity, increases automatism. Increases myocardial oxygen demand. Causes vasoconstriction of the abdominal organs, skin, mucous membranes, to a lesser extent - skeletal muscles. Increases blood pressure (mainly systolic), in high doses increases the systemic vascular resistance. The pressor effect can cause a short-term reflex slowdown of the heart rate.
Epinephrine (adrenaline) relaxes the smooth muscles of the bronchi, lowers the tone and motility of the gastrointestinal tract, dilates the pupils, and helps to lower intraocular pressure. Causes hyperglycemia and increases plasma free fatty acids.
Pharmacokinetics
It is metabolized with the participation of MAO and COMT in the liver, kidneys, and gastrointestinal tract. T1 / 2 is a few minutes. It is excreted by the kidneys.
Penetrates the placental barrier, does not penetrate the BBB.
Excreted in breast milk.
Indications of the active substances of the drug Adrenaline hydrochloride-Vial
Allergic reactions of immediate type (including urticaria, angioedema, anaphylactic shock) that develop with the use of drugs, serums, blood transfusions, food consumption, insect bites or the introduction of other allergens.
Bronchial asthma (relief of an attack), bronchospasm during anesthesia.
Asystole (including against the background of acutely developed third-degree AV block).
Bleeding from the superficial vessels of the skin and mucous membranes (including from the gums).
Arterial hypotension that does not respond to adequate volumes of replacement fluids (including shock, trauma, bacteremia, open heart surgery, renal failure, chronic heart failure, drug overdose).
The need to lengthen the action of local anesthetics.
Hypoglycemia (due to insulin overdose).
Open-angle glaucoma, during eye surgery - conjunctival edema (treatment), for pupil dilation, intraocular hypertension.
In order to stop bleeding.
Priapism treatment.
Dosage regimen
The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen.
Individual. Enter s / c, less often - i / m or i / v (slowly). Depending on the clinical situation, a single dose for adults can range from 200 ?g to 1 mg; for children - 100-500 mcg. The solution for injection can be used as eye drops.
Topically used to stop bleeding - use tampons moistened with epinephrine solution.
Side effect
From the side of the cardiovascular system: angina pectoris, bradycardia or tachycardia, palpitations, increase or decrease in blood pressure; when used in high doses - ventricular arrhythmias; rarely - arrhythmia, chest pain.
From the nervous system: headache, anxiety, tremors, dizziness, nervousness, fatigue, psychoneurotic disorders (psychomotor agitation, disorientation, memory impairment, aggressive or panic behavior, schizophrenic disorders, paranoia), sleep disturbances, muscle twitching.
From the digestive system: nausea, vomiting.
From the urinary system: rarely - difficult and painful urination (with prostatic hyperplasia).
Allergic reactions: angioedema, bronchospasm, skin rash, erythema multiforme.
Others: hypokalemia, increased sweating; local reactions - pain or burning at the site of the i / m injection.
Contraindications for use
Hypertrophic obstructive cardiomyopathy,
pheochromocytoma,
arterial hypertension,
tachyarrhythmia,
Ischemic heart disease,
ventricular fibrillation,
pregnancy,
lactation period,
hypersensitivity to epinephrine.
Application during pregnancy and lactation
Epinephrine (adrenaline) crosses the placental barrier and is excreted in breast milk.
Adequate and strictly controlled clinical studies of the safety of epinephrine use have not been conducted. Application during pregnancy and lactation is possible only in cases where the expected benefit of therapy to the mother outweighs the potential risk to the fetus or child.
Application in children
Use with caution in children.
Use in elderly patients
Use with caution in elderly patients.
special instructions
Use with caution in metabolic acidosis, hypercapnia, hypoxia, atrial fibrillation, ventricular arrhythmia, pulmonary hypertension, hypovolemia, myocardial infarction, shock of non-allergic genesis (including cardiogenic, traumatic, hemorrhagic), with thyrotoxicosis, vascular a history of arterial embolism, atherosclerosis, Buerger's disease, cold injury, diabetic endarteritis, Raynaud's disease), cerebral atherosclerosis, angle-closure glaucoma, diabetes mellitus, Parkinson's disease, convulsive syndrome, prostatic hypertrophy; simultaneously with inhalation agents for anesthesia (fluorothane, cyclopropane, chloroform), in elderly patients, in children.
Epinephrine should not be injected IV, since severe peripheral vasoconstriction can lead to the development of gangrene.
Epinephrine can be used intracoronary for cardiac arrest.
For arrhythmias caused by epinephrine, beta-blockers are prescribed.
Drug interactions
Epinephrine antagonists are ?- and ?-adrenergic receptor blockers.
Non-selective beta-blockers potentiate the pressor effect of epinephrine.
When used simultaneously with cardiac glycosides, quinidine, tricyclic antidepressants, dopamine, means for inhalation anesthesia (chloroform, enflurane, halothane, isoflurane, methoxyflurane), cocaine, the risk of arrhythmias increases (simultaneous use is not recommended, except in cases of extreme necessity); with other sympathomimetic agents - increased severity of side effects from the cardiovascular system; with antihypertensive drugs (including diuretics) - a decrease in their effectiveness; with ergot alkaloids - an increase in the vasoconstrictor effect (up to severe ischemia and the development of gangrene).
MAO inhibitors, m-anticholinergics, ganglion blockers, thyroid hormone preparations, reserpine, octadine potentiate the effects of epinephrine.
Epinephrine reduces the effects of hypoglycemic agents (including insulin), antipsychotics, cholinomimetics, muscle relaxants, opioid analgesics, hypnotics.
With simultaneous use with drugs that lengthen the QT interval (including astemizole, cisapride, terfenadine), an increase in the duration of the QT interval occurs.