Universal reference book for medicines
Product name: ADRENALINE (ADRENALINE)

Active substance: epinephrine

Type: Alpha-, beta-adrenomimetic

Producer: MOSCOW ENDOCRINE PLANT (Russia)
Description of the active substance :.
This information is a reference and it is not enough that the drug was prescribed by a doctor.
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PHARMACHOLOGIC EFFECT
Adrenomimetic, has a direct stimulating effect on? - and? -adrenoreceptors.

Under the influence of epinephrine (adrenaline) due to the stimulation of β-adrenoreceptors, the content of intracellular calcium in smooth muscles increases.Activation?
1- adrenoreceptors increases the activity of phospholipase C (via G-protein stimulation) and the formation of inositol triphosphate and diacylglycerol. This facilitates the release of calcium from the sarcoplasmic reticulum depot. Activation? 2- adrenoreceptors leads to the opening of calcium channels and an increase in calcium intake into cells.
Stimulation of α-adrenoreceptors induces G-protein-induced activation of adenylate cyclase and an increase in cAMP production.
This process is the trigger mechanism for the development of reactions from various target organs. As a result of stimulation? 1- adrenoreceptors in the tissues of the heart there is an increase in intracellular calcium. With stimulation? 2- adrenoreceptors, 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 the frequency and strength of the heart, stroke and minute volume of the heart. Improves AV-conductivity, increases automatism. Increases myocardial oxygen demand. It causes constriction of the vessels of the abdominal organs, skin, mucous membranes, to a lesser extent - skeletal muscles. Increases blood pressure (mainly systolic), in high doses increases OPSS. The pressor effect can cause a short-term reflex slowing 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, helps lower the intraocular pressure.
It causes hyperglycemia and increases the content of free fatty acids in the plasma.
PHARMACOKINETICS
Metabolized with the participation of MAO and COMT in the liver, kidneys, gastrointestinal tract.
T 1/2 is a few minutes. It is excreted by the kidneys.
Penetrates through the placental barrier, does not penetrate the GEB.

Excreted in breast milk.

INDICATIONS
Allergic reactions of immediate type (including urticaria, angioedema, anaphylactic shock), developing with the use of drugs, serums, blood transfusions, eating foods, insect bites or other allergens.

Bronchial asthma (arresting an attack), bronchospasm during anesthesia.

Asystole (including on the background of acute development of AV-blockade of the third degree).

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, kidney failure, chronic heart failure, drug overdose).

The need to lengthen the action of local anesthetics.

Hypoglycemia (due to an overdose of insulin).

Open angle glaucoma, with surgical operations on the eyes - swelling of the conjunctiva (treatment), for dilated pupils, intraocular hypertension.

In order to stop bleeding.

Treatment of priapism.

DOSING MODE
Individual.
Enter s / to, rarely - in / m or / in (slowly). Depending on the clinical situation, a single dose for adults can be from 200 μg to 1 mg; for children - 100-500 mcg. The solution for injection can be used as eye drops.
Locally used to stop bleeding - use tampons, moistened with a solution of epinephrine.

SIDE EFFECT
From the side of the cardiovascular system: angina, bradycardia or tachycardia, palpitation, increase or decrease in blood pressure;
when used in high doses, ventricular arrhythmias; rarely - arrhythmia, pain in the chest.
From the side of the nervous system: headache, anxiety, tremor, dizziness, nervousness, fatigue, psychoneurotic disorders (psychomotor agitation, disorientation, memory impairment, aggressive or panic behavior, schizophreniform disorders, paranoia), sleep disturbance, muscle twitching.

From the digestive system: nausea, vomiting.

From the urinary system: rarely - labored and painful urination (with hyperplasia of the prostate gland).

Allergic reactions: angioedema, bronchospasm, skin rash, erythema multiforme.

Other: hypokalemia, increased sweating;
local reactions - pain or burning at the site of the / m injection.
CONTRAINDICATIONS
Hypertrophic obstructive cardiomyopathy, pheochromocytoma, arterial hypertension, tachyarrhythmia, IHD, ventricular fibrillation, pregnancy, lactation period, hypersensitivity to epinephrine.

PREGNANCY AND LACTATION
Epinephrine (adrenaline) penetrates the placental barrier, excreted in breast milk.

Adequate and strictly controlled clinical studies of the safety of epinephrine have not been carried out.
Application in pregnancy and lactation is possible only in cases where the expected benefit of therapy for the mother exceeds the potential risk to the fetus or child.
APPLICATION FOR CHILDREN
C use caution in children.

APPLICATION IN ELDERLY PATIENTS
C use caution in elderly patients.

SPECIAL INSTRUCTIONS
C is used 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), thyrotoxicosis, occlusive vascular diseases (in tons a history of arterial embolism, atherosclerosis, Buerger's disease, cold trauma, diabetic endarteritis, Raynaud's disease), cerebral atherosclerosis, angle-closure glaucoma, diabetes mellitus, Parkinson's disease,
convulsive syndrome, prostatic hypertrophy; simultaneously with inhalation means for anesthesia (flurotan, cyclopropane, chloroform), in elderly patients, in children.
Epinephrine should not be administered in / a, since a pronounced narrowing of the peripheral vessels can lead to the development of gangrene.

Epinephrine can be used intracoronary in cardiac arrest.

With arrhythmias caused by epinephrine, prescribe beta-blockers.

DRUG INTERACTION
Antagonists of epinephrine are blockers of? - and? -adrenoreceptors.

Non-selective beta-adrenoblockers potentiate the pressor effect of epinephrine.

When applied simultaneously with cardiac glycosides, quinidine, tricyclic antidepressants, dopamine, inhalation anesthesia agents (chloroform, enflurane, halothane, isoflurane, methoxyflurane), cocaine increases the risk of arrhythmias (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 agents (including with diuretics) - a decrease in their effectiveness; with alkaloids of ergot - increased vasoconstrictor effect (up to pronounced ischemia and development of gangrene).
MAO inhibitors, m-cholinoblockers, ganglion blockers, thyroid hormone preparations, reserpine, octadine potentiate the effects of epinephrine.

Epinephrine reduces the effects of hypoglycemic agents (including insulin), neuroleptics, cholinomimetics, muscle relaxants, opioid analgesics, hypnotics.

When used simultaneously with drugs that extend the QT interval (including astemizole, cisapride, terfenadine), the duration of the QT interval increases.


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