An acute decrease in blood pressure due to allergies, drug overdose, or other causes can lead to irreversible effects in the body and even death. To date, in medical practice, adrenaline hydrochloride is used to remove a patient from this condition. It, depending on the complexity of the situation, is administered to patients subcutaneously, intramuscularly or intravenously, and in the most severe cases - intracardially.
pharmachologic effect
The main effect of the drug is directly related to the effect on a- and b-adrenergic receptors, and in many ways it is similar to the effects of excitation of nerve fibers. With the introduction of adrenaline, the hydrochloride helps to narrow the vessels of all the organs of the abdominal cavity and partially skeletal muscles. Due to such a decrease in the clearance in the blood channels, an increase in blood pressure occurs .
However, it is worth noting that the effect of adrenaline on the body, in connection with exposure to b-adrenoreceptors, is less constant compared to norepinephrine. Moreover, the nature of changes in cardiac activity is very complex. Indeed, stimulation of adrenergic receptors promotes faster and stronger heart contractions, and at the same time, when blood pressure rises, the center of the vagus nerves is excited, which inhibits the function of the heart. That is why with hypoxia, the introduction of the drug can provoke arrhythmia.
In addition, the medicine causes the expansion of the pupils, the relaxation of the muscles of the intestines and bronchi. It has been proven that tissue metabolism is accelerated in patients, and the blood glucose level rises after the administration of a single dose of a drug such as adrenaline hydrochloride. The instructions for use also contain information that the medication restores the functional abilities of skeletal muscle tissue, including with overwork.
As for the central nervous system, therapeutic doses of the drug, as a rule, do not have a pronounced effect on it.
To whom is the drug indicated?
Adrenaline hydrochloride is used with a sharp decrease in blood pressure (in medicine this condition of the patient is called collapse). Such a crisis in a person can occur due to an overdose of medications, insect bites and acute allergic reactions.
Another indication for the use of the drug is hypoglycemia, which occurs with an overdose of insulin. In this condition, the patient rapidly decreases not only blood pressure, but also the level of sugar in the blood.
In ophthalmology, the drug is prescribed for patients with increased intraocular pressure (glaucoma). In otorhinolaryngological practice, it is used as a vasoconstrictor.
In addition to the above indications, epinephrine hydrochloride is administered to patients with ventricular fibrillation.
Dosing system and method of application
Depending on the disease and its severity, the drug may be indicated to the patient subcutaneously, intramuscularly and intravenously. A 0.1% solution of 0.2 / 0.3 / 0.5 or 1 ml is used. Patients with acute cardiac arrest are injected with 1 ml of the drug, the same dosage is used for ventricular fibrillation. It is worth noting that the dosage scheme is selected exclusively by the doctor for each specific case.
In ophthalmology, to achieve the local vasoconstrictor action of adrenaline, hydrochloride is applied to the
mucous membranes of the eyes.
Attacks of bronchial asthma are stopped by administering the drug subcutaneously at 0.3 - 0.5 - 0.7 ml. But as for therapeutic doses of solutions of adrenaline for parenteral use, then, as a rule, they make up 0.3 - 0.5 - 0.75 ml for adult patients. Children, if necessary, the use of this medication, depending on age, is administered 0.1-0.5 ml.
The composition of the drug
Pure adrenaline hydrochloride is a slightly pinkish or white crystalline powder. Under the influence of oxygen and light, it is able to change. However, in this form, the drug does not reach the consumer. Before it can be used in medical practice, under aseptic conditions in pharmaceutical plants, it is diluted with a solution of hydrochloric acid. As preservatives, pharmacists use sodium metabisulfite and chlorobutanol.
Only after that, in pharmacies, patients can acquire a solution of adrenaline hydrochloride, completely ready for use.
Product release form
To date, this drug is available to the consumer only in the form of a 0.1% solution, which is available in bottles and ampoules. The volume of the first is 30 ml, but of the second - only 1 ml. Ampoules of 6 pcs. packaged in cardboard bundles.
In appearance, the solution resembles a completely transparent liquid without sediment and various undissolved elements.
To whom is the drug contraindicated?
Given that the main indication for the use of the drug is an increase in blood pressure due to the narrowing of blood vessels, it is logical that it should not be used categorically in patients with arterial hypertension.
Also, the drug is strictly prohibited with severe atherosclerosis, thyrotoxicosis and diabetes mellitus, because the pharmacological effect of this medication can not only worsen the course of the above ailments, but also lead to the most dangerous consequences. For example, myocardial infarction, stroke and others.
Do not use adrenaline hydrochloride during surgery, during anesthesia with cyclopropane or fluorotane.
It is also worth noting that this drug is strictly prohibited during pregnancy and lactation. And in combination with the drug "Oxytocin", the drug leads to increased intoxication.
Side effects
Despite the fact that with many ailments, the drug can save the patient’s life, with the same probability it can harm, if you do not take into account the individual characteristics of the patient or exceed the allowable dosage.
So, even with the proper use of the medicine, a person may feel dizzy, fearful, trembling, restless, and general weakness. In addition, the patient after administration of the drug may experience pallor of the skin (due to narrowing of blood vessels), sweating and a short-term increase in blood pressure. However, this side symptomatology, due to its short duration, does not require medical correction or complete drug withdrawal.
Those who are shown adrenaline hydrochloride, instructions for use warns of the possible development of cardiac arrhythmias, tachycardia, a sharp increase in blood pressure. In patients with coronary heart disease who are using the medicine, the risk of angina attacks is increased.
Overdose
Everyone knows that medicine is intended to be used in a clear dosage and only as directed by a doctor. Otherwise, the patient’s health is in great danger. And epinephrine hydrochloride is no exception.
If the permissible dosage of the solution is exceeded (even with subcutaneous administration), the patient immediately develops mydriasis and blood pressure rises rapidly. In addition, significantly increased heart rate, which in some cases can go into ventricular fibrillation. And if the patient has a sharp increase in hydrostatic pressure in the smallest vessels of the small circle and the permeability of the capillary wall, pulmonary edema may develop.
How to block the negative effects of the drug?
They are struggling with a number of adverse effects of adrenaline with the help of antagonistically acting α- and β-blockers. These include Anaprilin, Tropafen, Phentolamine, and others. Often, doctors also use high-speed nitrites to remove the effects of adrenaline. However, the use of the above groups of drugs is permissible only for mild manifestations of a number of side effects of an agent such as adrenaline hydrochloride (drug formula: 1-1- (3,4-dioxiphenyl) -2-methylaminoethanol hydrochloride).
If the patient using this medication has more serious complications, such as ventricular fibrillation or extensive pulmonary edema, the use of fast nitrites and various adrenergic blockers is not enough. To save patients in such cases, doctors conduct appropriate complex therapy, which may even include electrical defibrillation of the heart.
Conditions for dispensing the drug
It is logical that adrenaline-based medicine prohibits free sale to the final consumer. After all, self-medication with these means can lead to a lot of negative consequences, even with strict adherence to the dosing system. In addition, in some patients with the introduction of a small amount of the drug adrenaline hydrochloride (instructions indicate this), an acute allergic reaction may develop.
Therefore, before going to the pharmacy for this medicine, you should consult a doctor who will write a prescription. It is this document, which contains information about the quantity and dosage of the drug, should be presented to the pharmacist when buying a medication.
Drug interaction
Every doctor knows that using adrenaline with various symptoms is strictly prohibited. After all, such a combination has an additive effect and leads to intoxication.
This medicine is also not used to treat patients who take sleeping pills and narcotic analgesics. In addition, for allergy sufferers who systemically use antihistamines, any doctor will also refuse to write a prescription. Adrenaline hydrochloride in this case is not only dangerous to health - it may very well cause death.
A combination of the drug with inhalation anesthesia is not allowed, as this can lead to the development of complex heart diseases in the patient.
Analogues of the drug
Due to the fact that scientists do not stop at the achieved results and continue to work on the creation of new drugs, the adrenaline hydrochloride agent now has an impressive list of analogues. However, the choice of a drug similar in effect to adrenaline is carried out exclusively by the attending physician. In this case, the specialist is guided not only by the form and severity of the patient's illness, but also takes into account his individual characteristics.
The doctor can replace epinephrine hydrochloride with such medicines as Epinifrin, Tonogen, Glaucosan, Hydrochloric Adrenaline, Suprarenaline, Epinephrine Hydrochloride, Levorenin, Appi, Renostiptitsin, Suprarenin , "Glaucon", "Epirenan", "Adrenamine", "Hypernefrin", "Stiptyrenal", "Paranefrin", "Glauconin", etc.
Despite the impressive list of analogues, you do not need to think that they can be freely bought at the pharmacy. When purchasing adrenaline hydrochloride, a Latin prescription will need to be presented to a pharmacist. The same is required if you wish to purchase any of the above medicines.