Adrenaline (epinephrine) is a hormone and neurotransmitter and used as a medication that regulates many functions and is normally produced both by the adrenal glands and some neurons in the medulla oblongata. Adrenaline is an important hormone in the fight-or-flight response by increasing blood flow to muscles, output of the heart by acting on the SA node and blood glucose levels. Adrenaline is a catecholamine with a catechol nucleus and an ethylamine side chain that activates the alpha1, alpha2, beta1, beta2 receptors. It can be used topically, inhalation, IM injection and IV (poorly absorbed by gut, so not used orally).
Adrenaline is generally the most commonly used term worldwide, with the exception of the USA which generally use the term epinephrine.
Pharmacokinetics:
Protein binding is around 15–20%; metabolized in liver by COMT and MAO; onset of action is rapid; the elimination half-life is 2 minutes; duration of action is few minutes; excretion is in the urine
Uses for Adrenaline:
Delay absorption of local anaesthetics; control of superficial bleeding; hypotension during septic shock; mydriasis during eye procedures; bronchodilation in asthma; anaphylaxis; severe croup
Contraindications:
No absolute contraindications, but use with caution in pregnancy (lack of well controlled trials); labor (adrenaline opposes the actions of oxytocin on the uterus and could delay labor); older person (start with lower dose)
Side effects:
Hypertension; angina pectoris (activation of receptor increases cardiac work and oxygen demand); arrhythmias; anxiety, nervousness and agitation; palpitations; sweating; necrosis at injection site (esp if repeated)
Trade Names:
EpiPen, AnaPen, Adrenaclick, Adrenalin®
Chemical formula: C9H13NO3
In Australia, adrenaline is an S4 drug and is listed on National Podiatry Scheduled Medicines List for authorised podiatrists to use for anaphylaxis.
In the UK, it is classified as a Prescription Only Medicine and in the USA, it is Rx.
Examples of Other Sympathomimetic drugs (Adrenergic Agonists):
| Vasopressor agents: | Cardiac Stimulants: | CNS Stimulants: | Bronchodilators: | Anoretics: |
| Noradrenaline Ephedrine Phenylephrine Dopamine | Adrenaline Dobutamine Isoprenaline | Amphetamine Methamphetamine Dexaamphetamine | Isoprenaline Salbutamol Salmeterol Terbutaline | Amphetamine Fenfluramine |
| Uterine Relaxants: | Nasal Decongestants: | |||
| Salbutamol Terbutaline Ritodrine | Xylometazoline Pseudoephedrine |
Related Topics:
First Aid for Anaphylaxis | Adrenaline in Local Anaesthetics for Toe Injections | Adrenaline (Epinephrine) Injectors
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