Adrenaline + Sodium Metabisulphite Pharmacology
Adrenaline + Sodium Metabisulphite
1.Adults:0.3 to 0.5 mL (0.3-0.5mg), administered slowly. The dose may be repeated every 10 minutes if necessary. In severe reactions the dose can be increased to 1mL.
2.Elderly patients:The usual adult dose is used but should be given very slowly with caution as elderly patients may be more sensitive to adrenaline.
3.Children (up to 12 years of age):100 - 500ug depending on age, or 50ug for infants under 1 year
2.Severe hypertension leading to pulmonary oedema and cerebral haemorrhage.
3.Overdosage of adrenaline can result in severe metabolic acidosis because of elevated blood concentration of lactic acid.
Subcutaneous: 5 to 15minutes
Inhalation: Within 5 minutes
Subcutaneous: 1 to 4 hours
Inhalation: 1 to 3 hours
2.Shock other than anaphylactic shock,
3.Angle closure glaucoma,
4.Anaesthesia of extreamities,
8.Organic brain damage,
11.Along general anaesthesia with halogenated hydrocarbons or cyclopropane.
7.Parkinson`s disease(ophthalmic preparation)
5.To restore cardiac rhythm in cardiac arrest
7.Prolong duration of anaesthesia
9.Open angle glaucoma.
Cardiac glycosides: May make cardiac arrhythmias more likely.
Ergot alkaloids and phenothiazines: May reverse the pressor effects of adrenaline.
Antihistamines: Pressor effect may be potentiated.
Halogenated hydrocarbon anaesthetics: Sensitise the myocardium to the effects of catecholamines leading to serious arrhythmias.
Oxytocic drugs: May cause severe persistent hypertension.
Sympathomimetic drugs: Additive effects and increased toxicity. May induce serious cardiac arrhythmias.
Tricyclic antidepressants: Pressor response may be potentiated.
Adults: Starts with 0.1 to 0.5mg (0.1 to 0.5ml of a 1: 1,000 solution) S.C. or I.M. Repeat as required at 10 to 15minute intervals. Alternatively 0.1 to 0.25mg (1 to 2.5ml of a 1: 10,000 solution) I.V.; slowly over 5 to 10 minutes. Repeated if required at every 5 to 15minutes or followed by 1 to 4mcg/minute I.V. infusion.
Children: 0.01mg/kg (0.01ml/kg of a 1: 1000 solution) S.C. Dose not to exceed 0.5mg. Repeated as required; at every 20 minutes to 4hour intervals. Alternatively 0.02 to 0.025 mg/kg (0.004 to0.005 mi/kg) of a 1:200 solution. Repeat if required but not to exceed than four times daily. Alternatively
To restore cardiac rhythm in cardiac arrest:
Starts with 0.5 to 1mg (5 to 10ml of 1: 10,000 solutions) diluted to 10ml and administered I.V. or intra cardiac. During resuscitation 0.5 to 1mg I.V. every 5minutes or injected through endotracheal tube. Administer 10ml containing 1ml adrenaline (0.1mg/ml) by 5 rapid insufflations directly in to the tube and followed by 5 rapid insufflations.
Adults: I.V.: 100mcg to 250mcg injected slowly.
Infants: 50mcg initial dose repeated at 20 to 30 minutes intervals in asthma attacks.
Resuscitation for children and neonates: 0.iml/kg of 1: 10000solution I.V.
As a haemostatic agent:
Adults: 1: 50,000 to 1: 1000 applied topically.
To prolong local anaesthetic effect: 1:500000 to 1: 50000 mixed with local anaesthetic agent.
Intra spinal use: 0.2 to 0.4ml of 1: 2000 solutions added to anaesthetic fluid to prolong anaesthetic action.
Nasal congestion, local superficial bleeding: Instill 1 to 2 drops of solution.
Open angle glaucoma: 1 to 2 drops instill daily or twice daily.
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