In the human body, the adrenal medulla is involved in the synthesis of adrenaline - a structure that is regulated by the nervous system. At the same time, the nervous system itself is the main source of catecholamine hormones, which, in addition to adrenaline, include norepinephrine and dopamine.

In medicine, synthetic or natural analogues of adrenaline are used. In the first case, they are obtained by chemical combination of substances, and in the second - from the tissue of the adrenal glands of animals.

In international medical practice, each active substance corresponds to an international non-proprietary name (INN). The generic analogue of adrenaline is epinephrine.

Pharmaceutical companies produce two forms of the drug.

• Epinephrine hydrochloride is a white crystalline powder. It is considered normal if the color of the powder has a pinkish tint. Under the influence of sunlight and oxygen, the drug is able to change color. For medicinal purposes, it is used in the form of a solution of adrenaline hydrochloride, which must be diluted in a solution of hydrochloric acid. The finished solution is absolutely transparent and colorless.
• Adrenaline hydrotartrate is a crystalline powder, the color of which can be pure white or with a grayish tint. It cannot be diluted in alcohol, so an adrenaline solution is prepared by dissolving the powder in water.

As follows from the instructions for the use of adrenaline, the biochemistry of the drugs is different. For this reason, the diluted adrenaline preparation hydrotartrate is used in a larger dosage.

What forms does epinephrine come in?

Pharmacists offer the following form of release of the drug:

• adrenaline hydrochloride - 0.1% solution;
• adrenaline hydrotartrate - 0.18% solution.

The preparations are intended for intramuscular or intravenous administration, or for topical use. In the first case, the drug is produced in ampoules with a capacity of 1 ml, and in the second - in vials with a capacity of 30 ml.

Adrenaline is produced in the form of tablets, as well as in granules of plant origin.

Pharmacological properties

Adrenaline is a catabolic hormone that affects all metabolic processes in the human body.

The pharmacological effect of epinephrine is as follows:

• increases blood sugar levels;
• relieves spasms that occur in the bronchi;
• increases blood pressure;
• relieves manifestations arising from allergic reactions;
• increases vascular tone;
• prevents the production of glycogen in the liver and muscles;
• improves the absorption and processing of glucose by tissues;
• enhances the action of enzymes that promote the oxidation of glucose;
• improves the process of disintegration of adipose tissue, preventing its further formation;
• enhances muscle activity, reducing the feeling of fatigue;
• improves the activity of the central nervous system, giving a feeling of cheerfulness, and increasing mental activity;
• has a beneficial effect on the adrenal cortex, pituitary gland and hypothalamus;
• activates the activity of the hypothalamus, stimulating the natural production of adrenaline;
• increases blood clotting.

Adrenaline hydrotartrate and hydrochloride have a powerful anti-inflammatory and anti-allergic effect, effectively relieving severe manifestations of the disease by acting on certain receptors. As a result, the pharmacology of a substance makes it possible to desensitize body tissues to the substances that caused the side effect.

In moderate concentrations, the drug analogue of adrenaline helps to strengthen muscle tissue and myocardium. High concentrations of epinephrine increase the breakdown of proteins and their uptake by body tissues.

Chemical formula - adrenaline C 9 H 13 NO 3

When is epinephrine indicated?

There are the following indications for the use of adrenaline.

• Sudden allergic reactions, including anaphylactic shock, which develop due to various reasons. Epinephrine effectively relieves symptoms of drug and food allergies, reactions to insect bites or blood transfusions.
• A sudden drop in blood pressure, resulting in impaired blood circulation in the internal organs.
• Severe attacks of bronchial asthma.
• Sudden drop in blood sugar caused by too much insulin.
• Diseases that develop as a result of a decrease in potassium ions in the blood.
• Increased intraocular pressure.
• Sudden cardiac arrest.
• Surgical intervention on the visual organs.
• The process of bleeding from vessels located close to the surface of the skin.
• Severe disorders of the heart.
• In cases of development of priapism - a pathologically persistent erection.

As indicated in the instructions for use of epinephrine hydrochloride and adrenaline hydrotartrate, they are successfully used to relieve mucosal edema in diseases of the ear, throat and nose, enhancing the effect of painkillers.

Adrenaline tablets are taken for heart diseases leading to angina pectoris and a decrease in vascular tone. Also, this form of the drug is indicated for conditions caused by increased anxiety and chest pain.

When is epinephrine contraindicated?

Solutions of adrenaline hydrotartrate and hydrochloride are contraindicated in the following cases:

• if blood pressure does not decrease for a long time;
• with aortic aneurysm and vascular atherosclerosis;
• with hypertrophic cardiomyopathy;
• with hyperthyroidism;
• in the presence of a hormone-dependent tumor of the adrenal glands;
• with tachyarrhythmia;
• in case of hypersensitivity to the active substance.

For women during pregnancy and lactation, adrenaline injection is prescribed only if the benefits of its use are higher than the possible harm to the child. For children and the elderly, epinephrine is prescribed only when absolutely necessary.

How to use adrenaline

Adrenaline in ampoules is administered either subcutaneously or intramuscularly, or intravenously. Moreover, in the latter case, it must be administered using a dropper. The drug must not be injected into the artery, since the effect of vasoconstriction provided by it can cause gangrene.

The dosage of the drug is prescribed individually. In general, the doses recommended for use are as follows:

• a single dose for adults varies between 0.2-1 ml;
• if a child is undergoing treatment, then the minimum dosage will be 0.1 ml, and the maximum - 0.5 ml.

Adverse reactions

Adrenaline increases physical endurance, reaction speed, alertness and heart rate. Side effects of epinephrine are that it can distort the perception of reality and cause dizziness.

The use of the drug can increase irritability and cause a feeling of anxiety, which is due to an increase in blood glucose levels. In high doses, adrenaline can provoke heart failure, insomnia and reduce stress resistance.

Overdose

With an overdose of adrenaline, the following conditions occur:

• a significant increase in vascular tone, causing arterial hypertension;
• pupil dilation;
• chaotic increase and decrease in heart rate;
• decrease in body temperature and pallor of the skin;
• ventricular and atrial fibrillation;
• nausea and vomiting;
• causeless feeling of anxiety and fear;
• hand trembling;
• headaches and stroke;
• rupture of the heart muscle;
• pulmonary edema;
• kidney failure.

If 1 ml of the drug is effective in anaphylactic shock, the introduction of 10 ml of adrenaline hydrotartrate is fatal. And to eliminate the symptoms of an overdose, it is necessary to inject drugs that reduce the sensitivity of receptors to the active substance, as well as drugs that can quickly lower blood pressure.

Interaction with other drugs

Adrenaline is not used with drugs that block the sensitivity of receptors to the active substance.

The simultaneous use of epinephrine in combination with drugs containing components used in the treatment of heart disease and increasing the heart rate can lead to the development of arrhythmias. For the same reason, this substance is not used when taking antidepressants and using inhalation anesthesia.

The combination of epinephrine with drugs that have antihypertensive effects, including diuretics, leads to a decrease in their effectiveness. Adrenaline is also not used if the patient is taking drugs based on ergot alkaloids.

The drug reduces the effectiveness of drugs that lower blood sugar levels, eliminate the symptoms of insomnia, and also relieve muscle tension.

Adrenaline analogs

Epinephrine is found in the following drugs:

• Mezaton;
• Dobutamine;
• Dopamine;
• Dopamine.

Bibliography

1. Baskakov V.P., Tsvelev Yu.V., Kira E.F. endometrial disease. - St. Petersburg,
2. Rakovskaya I.V., Vulfovich Yu.V. Mycoplasma infections of the urogenital tract. – M.: Medicine, 1995.
3. Miscarriage, infection, innate immunity; Makarov O.V., Bakhareva I.V. (Gankovskaya L.V., Gankovskaya O.A., Kovalchuk L.V.) - "GEOTAR - Media". - Moscow. - 73 p.-2007.
4. Basic principles of the method of ozone therapy in medicine. Posibnik for likariv. Kharkiv 2001 - 99 p. Scientific publication
5. Viral, chlamydial and mycoplasmal diseases of the genitals. Guide for the doctor. - M.: Information and publishing house "Filin", 1997. -536 p.
6. Zaporozhan V.M., Tsegelsky M.R. Obstetrics and gynecology. - K .: Health, 1996.-240 p.

Lethal doses! Everyone should know this!

Scientists have established lethal doses for humans of various everyday products, substances and phenomena.

Everything has a lethal dosage, even water, salt and sugar, let alone tobacco, alcohol, and even more so hard drugs like heroin or amphetamine, the slightest excess of which can lead to overdose and death. The article provides a list of lethal doses of what we encounter in everyday life from water to sunlight.

The concept of "lethal dose" means the amount of a substance after which almost any normal person has 100% death. Due to the fact that all people are different, for some, an overdose with subsequent death can occur much earlier and from much smaller amounts, so do not think that “up to” means you can, do not try to find the limit of your body! And remember - the use of any drugs causes irreparable harm to health and leads to the development of drug addiction!

Lethal doses of various substances when taken orally

Doses of acute poisoning are given for adults who are not addicted to poison

Name	Lethal dose (gram/person)	Type of damage to the body
Adrenalin	0.005-0.010 (s / c, inside - harmless)	Hypertensive crisis
Nitric acid (25%)	5-10	chemical burn
Aymalin	2-3
Aconite (dry plant)	1-2
Aconitine	0,0015-0,006
Aminorex	1,0
Amphetamine	0,12-0,2
Analgin	5-8	Inhibition of hematopoiesis
Aniline	4-25
Antipyrine	5-30
Apomorphine	0,6
Arecoline	0,05
Aspirin	10
Atropine	0,1-1
Acetanilide	4
Acetone	75
barium carbonate	0,5-4,0
Colchicum (seeds)	2-5
Benzene	10-30
Pale grebe (fresh mushroom)	30-50	Liver damage
Boric acid	2-20
Bromine	1,0
Bromisoval	3-10
Bromoform	15
warfarin	3,5-5
Veratrin	0,01-0,02
Bismuth nitrate basic	8
Heroin (for non-addicts)	0,05-0,075
hydroquinone	2
Hyoscyamine	0,1-1,0
Glycerol	50-500
Homatropin	0,7-7,0
1,2-dibromoethane	6
Diphenhydramine	0,5-2
dimethyl sulfate	1-5
4,6-Dinitro-o-cresol	0,35-2
2,4-Dinitrophenol	1,0
Dichlorobenzene (ortho- and meta-)	15
1,2-Dichloroethane	6
diethyl ether	25-30
Dulcin	5	Liver damage
Iron dichloride	30
inkstone	3-50
iodine	2-3
Iodine tincture (pharmacy)	30
iodoform	3
Iproniazid	0,6
Cadmium sulfate	0,03-0,05
Potassium bichromate	0,7-3,0
Potassium bromide	20
Potassium carbonate	20
Potassium nitrate	8
Potassium permanganate	5
Potassium chlorate	10-15
Potassium chloride	15
Cantharidin	0,04-0,08
Cocaine	0,5-1,0	Stimulation followed by depression of the central nervous system.
cocculus seeds	2-3	convulsions
Colchicine	0,05-0,1
Konyin	0,5-1,0
Corazol	6	Convulsive
Caffeine	10
Lemon acid	20
lithium chloride	8
Maleic acid	10
Copper sulfate (copper sulfate)	8
Methadone	0,1
Metaldehyde	4
methylene chloride	20
methamphetamine	0,35-1,5
Methyl alcohol (methanol)	20-100
Juniper (medicinal raw material)	20
Morphine	0,3	Respiratory depression
Formic acid	30
Arsenic(III) oxide (white arsenic)	0,06-0,3
Nalorfin	0,2
sodium azide	0,3-0,5
sodium iodide	10
sodium nitrate	10-15
sodium nitrite	2-4	Methemoglobinemia
Sodium oxalate	15
Naphthalene	2-20
Nicotine	0,04-0,1
Paraldehyde	25-30
Parathion	1
Paracetamol	15	Liver damage
Pethidine	1,0
Picrotoxin	0,02	convulsions
Pilocarpine	0,06	Dehydration
Primalin	0,4
Prozerin (neostigmine)	0,06
emetic nut seeds	0,75-3,0	Convulsive
Sabinol	0,1-0,2
Lead acetate	5-30
Sevin	0,3-0,5
Rochelle salt	20-50
Silver nitrate	10-30
Sulfuric acid conc.	1-10	chemical burn
Turpentine	60
Hydrochloric acid conc.	20	chemical burn
streptocide	20
Strychnine	0,1-0,3	convulsions
Corrosive sublimate	0,2-1,0	Kidney damage
Tavegil	0,5-2
Thallium sulfate	0,6
Carbon tetrachloride	3-5	Liver damage
Tranylcyproline	0,5
Tricresyl Phosphate	2
tripelennamine	2
Acetic acid (70%)	50	chemical burn
Acetic acid (96%)	20	chemical burn
Phenacetin	5-10	Liver damage
Phenol	1-30
Physostigmine	0,006-0,01
Formalin (35%)	10-50
Quinine	5-8
Chloroform	20-70	Liver damage
Chlorcholine chloride	0,7-7,0
Chromium(VI) oxide	1-2
cyanamide	40-50
Cyclodol	1-7
zinc oxide	10
Zinc chloride	3-5
Zinhofen	2-6
hellebore roots	1-2
Hellebore seeds	10
Saffron seed	5-10
Oxalic acid	5	Precipitation of calcium oxalate in the kidneys, acidosis.
Eucalyptus oil	20
ethylene glycol	150	Kidney damage
Ethanol	300-800
Ephedrine	1-2	Hypertensive crisis

1. Water

Lethal dose - 14 liters, drunk in a short time (3 - 5 hours).

1.5-2 liters of water is the daily norm of a healthy person. Busting 3-4 times can lead to the so-called water poisoning, or water intoxication, a violation of the water-salt metabolism in the body. The kidneys simply do not have time to remove everything drunk from the body, the salt concentration will drop, and water will begin to fill the intracellular environment. As a result, swelling of the brain, lungs, etc. Death comes from washing out the salts needed by the body, so when washing the stomach with water, do not forget to salt it.

Every 1000 kilocalories eaten should be washed down with a liter of water. The average daily diet of a city dweller is 2000-2500 kcal, the total daily norm is 2-2.5 liters. A person receives about a liter of liquid with food, in the wet residue - 1.5-2 liters, the daily norm of a healthy person. Busting 3-7 times can lead to the so-called water poisoning, or water intoxication - a violation of the water-salt metabolism in the body. The kidneys simply do not have time to remove everything drunk from the body, the salt concentration will drop, and water will begin to fill the intracellular environment. As a result, swelling of the brain, lungs, etc. In well-known medical cases of water poisoning with a fatal outcome, people drank at least 7 liters in less than a day. If you drain the cooler alone during the working day, and then - the end.

In January 2007, the Nintendo Wii console was played on the morning show at the KDND radio station in the California town of Sacramento. The competition was called Hold Your Wee for a Wii (something like "Don't pee - excel"), and the participants who were in the studio had to drink as much water as possible without the opportunity to "exit". Jennifer Strange, 28, a mother of three, was one of the finalists but did not win the prize. Later that day, she complained of a severe headache and even had to take time off from work. The next morning, she was found dead - the doctors pronounced her dead as a result of water intoxication. During the radio show, Jennifer drank about 7.5 liters of water.

2. Salt

The lethal dose is 3.0 g/kg (grams per kilogram of body weight).

The daily need for salt is 1.5-4 g, and in hot climates, as a result of increased sweating, it is several times higher.

Ordinary edible salt in large quantities is poison - the lethal dose is 100 times the daily intake and is 3 grams per 1 kilogram of body weight, that is, for a person weighing 83 kg, the lethal dose is a quarter of a kilogram pack.

Due to an excess of salt in the blood, blood pressure will rise sharply (which is dangerous in itself), and this will be accompanied by severe edema (1 g of sodium chloride leads to a delay in the body of 100 ml of fluid). Most likely, swelling of the brain and lungs will occur, and as a result, the end.

3. Sugar

Lethal dose of sugar: 29.7 g/kg (grams per kilogram of body weight).

146 reasons why sugar is ruining your health:

According to the latest data from American researchers, sucrose (sugar):

1. Helps reduce immunity (effective immunosuppressant).

2. May cause a violation of mineral metabolism.

3. Able to lead to irritability, excitement, impaired attention, childish whims.

4. Reduces the functional activity of enzymes.

5. Helps reduce resistance to bacterial infections.

6. May cause kidney damage.

7. Reduces the level of high density lipoproteins.

8. Leads to a deficiency of the trace element chromium.

9. Contributes to the occurrence of cancer of the breast, ovaries, intestines, prostate, rectum.

10. Increases glucose and insulin levels.

11. Causes a deficiency of the trace element copper.

12. Violates the absorption of calcium and magnesium.

13. Impairs vision.

14. Increases the concentration of the neurotransmitter serotonin.

15. May cause hypoglycemia (low glucose levels).

16. Promotes an increase in the acidity of digested food.

17. May increase adrenaline levels in children.

18. Leads to malabsorption of nutrients.

19. Accelerates the onset of age-related changes.

20. Promotes the development of alcoholism.

21. Causes caries.

22. Promotes obesity.

23. Increases the risk of developing ulcerative colitis.

24. Leads to exacerbation of peptic ulcer of the stomach and duodenum.

25. Can lead to the development of arthritis.

26. Provokes attacks of bronchial asthma.

27. Promotes the occurrence of fungal diseases.

28. Can cause the formation of gallstones.

29. Increases the risk of coronary heart disease.

30. Provokes exacerbation of chronic appendicitis.

31. Promotes the appearance of hemorrhoids.

32. Increases the likelihood of varicose veins.

33. May lead to an increase in glucose and insulin levels in women using hormonal birth control pills.

34. Contributes to the occurrence of periodontal disease.

35. Increases the risk of developing osteoporosis.

36. Increases acidity.

37. May impair insulin sensitivity.

38. Leads to a decrease in glucose tolerance.

39. May reduce the production of growth hormone.

40. Can increase cholesterol levels.

41. Promotes an increase in systolic pressure.

42. Causes drowsiness in children.

43. Can cause multiple sclerosis.

44. Causes a headache.

45. Violates the absorption of proteins.

46. ​​Causes food allergies.

47. Promotes the development of diabetes.

48. In pregnant women, it can cause toxicosis.

49. Causes eczema in children.

50. Predisposes to the development of cardiovascular diseases.

51. May disrupt the structure of DNA.

52. Causes a violation of the structure of proteins.

53. By changing the structure of collagen, it contributes to the early appearance of wrinkles.

54. Predisposes to the development of cataracts.

55. May cause vascular damage.

56. Leads to the appearance of free radicals.

57. Provokes the development of atherosclerosis.

58. Contributes to the occurrence of emphysema.

59. Sugar reduces the functionality of enzymes.

60. People with Parkinson's disease consume large amounts of sugar.

61. Sugar can cause permanent changes in the action of proteins in the body.

62. Sugar can lead to an increase in the size of the liver, as it promotes cell division.

63. Sugar can lead to an increase in the amount of fatty deposits in the liver area.

64. Sugar can cause an increase in the size of the kidneys and pathological changes in this organ.

65. Sugar can damage the pancreas.

66. Sugar contributes to fluid retention in the body.

67. Sugar is the #1 enemy of digestion.

68. Sugar can contribute to the development of myopia.

69. Sugar can harm the lining of the capillaries.

70. Sugar leads to weakening and fragility of the tendons.

71. Sugar can cause headaches and migraines.

72. Sugar plays a significant role in causing pancreatic cancer in women.

73. Sugar can negatively impact children's learning outcomes by making it difficult to learn new material.

74. Sugar can cause an increase in delta, alpha and theta brain waves.

75. Sugar can cause depression.

76. Sugar increases the risk of stomach cancer.

77. Sugar is the cause of dyspepsia (indigestion).

78. Excess sugar can increase the risk of developing gout.

79. Excess sugar can increase glucose levels in an oral glucose tolerance test for complex carbohydrates.

80. Excess sugar can increase insulin responses in people much on high sugar diets compared to low sugar diets.

81 High refined sugar diets impair learning ability.

82. Sugar can cause the less efficient functioning of two blood proteins, albumin, and lipoproteins, which can decrease the body's ability to handle fat and cholesterol.

83. Sugar can contribute to Alzheimer's disease.

84. Sugar can cause platelet stickiness.

85. Excess sugar can cause hormonal imbalances, as some thyroid hormones become overactive and others become overactive.

86. Sugar can lead to kidney stones.

87. Sugar can cause the hypothalamus to become very sensitive to a wide variety of stimuli.

88. Sugar can make you dizzy.

89. Diets high in sugar can cause free radical damage and oxidative stress.

Adrenaline is a drug that has a pronounced hypertensive (increasing blood pressure), vasoconstrictor, cardiostimulating and bronchodilator (eliminating bronchospasm) action. With intravenous administration, the therapeutic effect of adrenaline is almost instantaneous, with subcutaneous injection it develops after 5-10 minutes, with intramuscular injection it can vary. Consider when epinephrine is used - a solution for injection.

medicinal properties

When the drug is taken, blood vessels begin to constrict throughout the body. This occurs in the abdominal cavity, on the skin, in the kidneys and vessels of the brain. Also, the heart rate noticeably quickens, the tone of the smooth muscles of the intestine decreases (and the skeletal muscles have the opposite effect).

Indications for use

The drug is indicated for use in the following cases:

• Spontaneous allergic reactions (including hives and anaphylactic shock) from drugs, food, insect bites and other factors.
• Bleeding (used as a vasoconstrictor drug).
• Prolongation of the action of local anesthetics.
• Bronchial asthma and bronchospasm.
• A strong decrease in blood pressure (more than 1/5 of the norm for a person or in numerical terms below 90 for systolic or 60 for mean blood pressure).
• Asystole (cardiac arrest) of both instantaneous type and developed against the background of arrhythmia preceding it.

Methods of application and dosage

The injection can be administered by several different methods: in cardiac arrest, an injection is made into the heart, in other cases, depending on the specific situation, everything is administered locally, subcutaneously, intramuscularly or intravenously. Intramuscular administration gives a faster effect than subcutaneous.

The dosage varies depending on the age of the patient. For an adult, 0.3 to 0.75 ml is usually administered. You can repeat injections every 10 minutes, monitoring the reaction of the human body. A single dose cannot exceed 1 ml (approximately 1 mg), and a daily dose of 5 ml. If the patient's condition is severe enough, it is necessary to dissolve adrenaline in a ratio of 1 to 2 in an isotonic solution of sodium chloride (for example, 1 mg in 2 mg of solution) and slowly administer intravenously.

For children, the doses are much smaller and depend on how old the child is. If a one-year-old baby has a maximum dose of 0.15 ml, then at the age of up to 4 years it increases to 0.25 ml, at the age of up to 7 years - up to 0.4 ml, at the age of 10 years and older - up to 0.5 ml. The drug is administered to the child 1-3 times a day.

Also, if you just need to stop the person's bleeding, then the drug is applied topically with the help of tampons moistened in it, applied to the problem area.

Nuances of application

It is important not to inject the drug from the ampoule intra-arterially, because this will lead to excessive narrowing of the peripheral vessels, and this, in turn, to the development of gangrene.

If fluid is used in a state of shock, this does not preclude other measures, such as transfusion of plasma, blood, or saline solutions.

Prolonged use of the drug is strongly discouraged, because it can lead to the development of necrosis or gangrene. Also, the drug is not recommended for use during lactation. as it may be harmful to the child.

Side effects

In rare cases, the following side effects may occur from adrenaline:

• On the part of the cardiovascular system, sudden pain in the chest and heart rhythm disturbances can be observed.
• Occasionally, burning or pain may occur at the site of intramuscular injection of the drug.
• On the part of the digestive system, side effects can manifest themselves in the form of nausea and vomiting, the excretory system sometimes adds to them uncomfortable and / or difficult urination.
• Allergic reactions.
• Increased sweating.
• A severe drop in the level of potassium in the blood (manifested in the form of fatigue, weakness in the limbs; in severe cases, paralysis, intestinal obstruction and shortness of breath).
• Nervous state, weakness, fatigue, irritability, anxiety, sleep disturbances.

With the exception of nausea, vomiting and headaches, all other side effects occur no more often (and generally much less often) than one case per 100 uses of the drug.

The use of adrenaline does not lead to an absolute ban on driving vehicles and mechanisms, the doctor makes a decision in each case individually, based on the patient's condition and the side effects he has from the drug.

Overdose

In case of an overdose of adrenaline, there may be:

• Nausea, vomiting.
• Headache.
• Paleness and low temperature of the skin of the patient's body.
• Heart rhythm disturbances or pathological tachycardia (increase in heart rate over 90 beats per minute).
• With a severe overdose or in poor health patients - pulmonary edema, heart attack, stroke and even death.

Summing up

Adrenaline in the form of an injection solution can not only have a therapeutic effect, but, in some situations, even save a person's life. But in order for it not to harm a person, it is necessary to observe the correct dosage and take precautions. However, an experienced doctor, when contacting a medical institution, will take them into account and apply the injection solution (1 ml or less) as efficiently as possible.

What are Cortisone injections for, their effect

is a hormone produced by the adrenal medulla. For medical purposes, the drug Adrenaline is produced, the instructions for use of which must be studied before use.

Indications for it allow you to determine the area of ​​\u200b\u200buse of the hormone and select the necessary dose for administration in critical situations.

Thanks to this biologically active component, electrochemical impulses are transmitted between nerve cells, neurons and muscle tissue.

Activation of adrenaline production occurs during stress, when a person experiences fear, danger, shock, anxiety, pain and other situations that potentially threaten health or life.

And also the growth of adrenaline in the blood is observed with the active work of the muscles. Mobilizing the forces of the body, the chemical component performs the following functions:

• dilates blood vessels in the brain;
• contributes to the acceleration of the heart rate;
• increases blood pressure in the arteries;
• facilitates atrioventricular conduction.

At the same time, an increase in blood pressure can indirectly affect the normal functioning of the heart, causing bradycardia (heart rhythm disturbance in the direction of reducing the frequency of contractions of the heart muscle).

Adrenaline - production and use in medicine

The drug is obtained artificially or synthesized from the adrenal glands of cattle, sometimes pigs.

Adrenaline is a white powder with a bitter taste, having a fine crystalline structure. It is very difficult to dissolve in some liquids:

• water;
• alcohol;
• chloroform;
• ether.

In combination with alkalis and acids, it forms salts that dissolve easily.

Under the influence of light, the structure of Adrenaline is disturbed, it becomes pale pink, therefore, in the production of the drug, white light is avoided.

Release form

International non-proprietary name of the drug (INN) - .

Chemical formula: C₉H₁₃NO₃.

Adrenaline is produced in the form of salts:

• hydrochloride - a crystalline powder that has a white color, may be slightly with a pinkish tinge;
• hydrotartrate is a white or grayish crystalline powder, the solution of which is more stable.

For injections, the following forms of release of adrenaline are used:

• hydrochloride 0.1% solution - it is sold in 1 ml ampoules and in 30 ml vials. A solution of adrenaline hydrochloride is prepared by adding hydrochloric acid. Preservation of the drug is carried out with chlorobutanol and sodium metabisulphite;
• epinephrine hydrotartrate 0.18% - sold in 1 ml ampoules, easily soluble in water.

The solution for injection, ready for administration, is transparent and colorless.

Indications for the use of Adrenaline

In medicine, the drug is used in the following situations:

• cardiac arrest (asystole);
• anaphylactic shock (an allergic reaction of the body that manifests itself immediately);
• profuse bleeding from the surface of the skin and mucous membranes;
• bronchial spasms in patients with asthma;
• Adams-Stokes syndrome - fainting caused by a violation of the rhythm of the heart muscle;
• arterial hypotension (decrease in systolic pressure below 90 mm Hg or blood pressure below 60 mm Hg);
• the need for the use of vasoconstrictors;
• eye surgery associated with swelling of the conjunctiva, intraocular hypertension.

The drug is often used simultaneously with anesthetics to prolong the time of their action.

Adrenaline in cardiac arrest

In cardiac arrest, negative consequences for the body in the form of psychological and neurological disorders are minimized if help is provided within the first 7 minutes.

The first task is to restore breathing with the use of a ventilation mask or tracheal incubation.

Epinephrine is administered to increase peripheral vascular resistance and increase the volume of the heart muscle.

The cells of the body receive a sufficient amount of oxygen due to increased blood circulation. This process is facilitated by:

• slowing down of peripheral blood circulation;
• increased pressure in the coronary artery of the heart;
• increased cerebral perfusion pressure, which determines the level of blood supply to brain cells;
• decreased blood circulation in the carotid artery;
• a decrease in the concentration of carbon dioxide in the lungs with each free breath.

The level of carbon dioxide concentration determines whether resuscitation is effective.

Where to inject adrenaline hydrotartrate during cardiac arrest? According to the AHA (American Heart Association) recommendations from 2011, an injection of adrenaline into the heart is recognized as ineffective in cardiopulmonary resuscitation.

Intravenous or endotrachial administration of Adrenaline is carried out before defibrillation actions. When administered intravenously, the dose of the drug is 1 mg every 3 minutes; for endotrachial administration, the dose is 2–2.5 times higher.

If it is not possible to caterize the veins for the administration of the drug (when they sink), a needle 10–12 centimeters long is inserted into the heart. The puncture is made on exhalation. The intracardiac dose of the drug is 0.5 mg.

Adrenaline is not used for cardiac arrest caused by the use of cocaine, solvents and drugs that cause nervous system excitation.

Adrenaline for anaphylaxis

The use of adrenaline hydrotartrate is the best method for eliminating anaphylaxis.

The intake of an allergen in the human body can cause the development of anaphylactic shock. A negative reaction to an allergen manifests itself in a period of time from a few seconds to 5 hours.

If it is necessary to introduce an allergen to weaken the reaction of the immune system, adrenaline hydrotartrate is administered before the procedure.

If the first symptoms of an acute allergic reaction occur, EpiPen should be used urgently. This is a syringe tube containing 300 micrograms of Adrenaline. The syringe must be firmly inserted into the outer part of the thigh. The piston will work, after which the medicine will be injected. If there is no effect, it is permissible to re-use EpiPen after 5-15 minutes.

Anaphylactic shock

In anaphylactic shock Adrenaline hydrotartrate is administered intravenously or intramuscularly to increase the rate of action. The dose of the drug depends on the severity of the allergic reaction:

• if blood pressure falls below 50–60 mm Hg. Art., the dose of the drug will be from 3 to 5 ml of a 0.1% solution for injection. Isotonic sodium chloride solution is used in a volume of 10-20 ml to dilute the drug. The rate of bolus (intravenous, without the use of a dropper) administration of the drug will be 2–4 ml/sec.
• if blood pressure does not stabilize, and its level is below 70–75 mm Hg. Art., the dose of the administered drug is not reduced. Additionally, intravenous administration of a 1% solution of epinephrine is prescribed, which is connected to a bottle of isotonic sodium chloride solution with a volume of 200 ml. The rate of administration is 20 drops per minute. The dropper is placed 1 to 3 times a day.

The dose of the drug for bronchial asthma

Adrenaline acts as a bronchodilator in asthma. A decrease in the symptoms of an asthma attack is observed 5-10 minutes after the administration of the drug. If the patient's condition does not improve, Adrenaline is re-introduced.

First of all, it is necessary to introduce 0.5–0.75 ml of a 1% solution of the drug. With the continuation of asthma attacks, a dropper containing 0.3–0.5 mg of adrenaline is prescribed three times a day. The interval between procedures is 20 minutes.

The use of the drug for bleeding and glaucoma

Stopping bleeding, Adrenaline acts as a vasoconstrictor. The tool is applied:

• intravenous drip - Rate of administration in the range of 1-10 mcg / min (increase gradually);
• externally - the source of bleeding is blotted with a swab soaked in a solution of the drug Adrenaline.

For glaucoma, a 1–2% solution is used for instillation of the eyes, 1 drop 2 times a day.

Adrenaline during anesthesia

During anesthesia, adrenaline acts as a vasoprotector - a means of constricting blood vessels. Its use in anesthesia allows you to prolong the process of anesthesia, reduce the risk of bleeding during surgical procedures.

If spinal anesthesia is used, the dosage of the solution is 0.2-0.4 mg.

In local anesthetic drugs, the dose of the drug is 5 μg / ml.

If Fluorotan, Cyclopropane, Chloroform are administered as anesthetics, it is forbidden to use Adrenaline at the same time due to the high risk of arrhythmia in the patient.

Features of use for children

Adrenaline can be used to treat children in cases of:

• asystology in infants. For newborns, the dose is 10-30 micrograms per 1 kg of the child's weight intravenously every 3-5 minutes. Young children older than 30 days - 10 mcg per 1 kg of body weight intravenously. In case of urgent need, administer 100 mcg/kg additionally every 3-5 minutes. If there is no improvement in the condition, a dose of 200 mcg per 1 kg of the child's weight is allowed at time intervals of 5 minutes;
• in case of anaphylactic shock and bronchospasm, the maximum dose for administering the drug to a child is 0.3 mg (standard dose is 10 mcg / kg). In a critical situation, in the absence of an organism reaction, the input can be repeated three times in a quarter of an hour.

Contraindications, side effects, overdose

According to the instructions for the use of adrenaline, absolute contraindications to the use of the drug are:

• hypersensitivity to epinephrine;
• hypertrophic cardiomyopathy (thickening of the walls of the left or right ventricles);
• a tumor with hormonal activity -;
• high blood pressure (above 140/90 mm Hg);

• tachyarrhythmia - acceleration of the heart rate up to 100-400 beats / min;
• cardiac ischemia;
• scattered contraction of the fibers of the heart muscle (ventricular fibrillation);
• pregnancy and breastfeeding period.

As adverse reactions of the body to the administration of the drug, the following are distinguished:

• for the cardiovascular system: increased heart rate, arrhythmia, increased anxiety, bradycardia, tachycardia, abnormal blood pressure, chest pain;
• for the nervous system: tremor of the limbs, panic attacks, increased anxiety; headache, dizziness. Possible manifestations of memory impairment, paranoid attacks, mental disorders similar to the manifestation of schizophrenia;
• for the digestive system - nausea and vomiting;
• for the genitourinary system: painful urination (with prostate adenoma), increased erection;
• allergic manifestations: bronchospasm, skin rash.

Redness may occur at the injection site.

An overdose of adrenaline is manifested in the presence of pronounced side effects of the drug, accompanied by symptoms: dilated pupils, coldness of the skin.

The lethal dose is 10 ml of a 0.18% solution of epinephrine.

As a result of an overdose, pulmonary edema, renal failure and myocardial infarction may occur, so the use of the drug is permissible only for emergency indications as prescribed by a doctor.

Adrenaline is a hormone produced by the adrenal glands. It is always present in the body. But there are cases when, in shock or stressful situations, adrenaline is produced in an increased amount. And this allows a person to quickly respond to external influences, increase their activity and efficiency.

Very often in medicine, adrenaline obtained synthetically is used. This allows you to restart the most important systems and organs of a person and correct his physical and mental state in critical situations. The use of the hormone adrenaline is quite diverse and is carried out only under the supervision of doctors.

In medicine, the synthetic hormone adrenaline is used.

Adrenaline has the international non-proprietary name epinephrine. It belongs to the group of alpha-beta-agonists. It is produced by obtaining from the corresponding glands of animals or as a result of synthetic synthesis.

The drug is produced in the following forms:

1. Adrenaline hydrochloride is a powdery substance of white or white-pink color with crystals, which can change its qualities when interacting with light and oxygen. A ready-made solution of 0.1% adrenaline hydrochloride can be purchased at pharmacy kiosks in 1 ml ampoules or 10 ml bottles. It is colorless and odorless. It is used only in the form of injections. Not subject to heating.
2. Adrenaline hydrotartrate is a powdery substance of white or white-gray color with crystals that changes its characteristics when interacting with light and oxygen. It dissolves well in water, much worse in alcohol. Available as a 0.18% solution in ampoules or vials.

Adrenaline is also produced in tablet form or in the form of homeopathic granules and suppositories for local anesthesia.

The action of epinephrine hydrochloride and adrenaline hydrotartrate is practically the same. The second type of agent has a large molecular weight and its use in increased doses is allowed.

Pharmacological properties

Adrenaline increases the work of the heart and increases blood pressure

Once in the body, adrenaline acts on alpha and beta adrenoreceptors. Such a reaction is similar to the effect of irritation of sympathetic nerve fibers.

The main effects of the use of adrenaline:

• The hyperglycemic effect is achieved by raising the level of glucose in the blood and improving metabolic processes in tissues.
• The hypertensive effect is achieved by increasing the work of the heart and increasing the level.
• The vasoconstrictive effect is achieved by constriction of blood vessels in the mucous membranes and skin.
• The bronchodilator effect is achieved by relaxing the bronchi and relieving spasms.
• The anti-allergic effect is achieved by preventing the penetration of allergens and reducing the sensitivity of tissues to them.

Adrenaline-based drugs are well absorbed into the blood. With the introduction of the drug through the veins, the effect appears instantly, and the action lasts up to 2 minutes. With a subcutaneous injection, the effect is noticeable within a few minutes.

The severity and strength of the impact depends on the speed at which adrenaline is injected. When the hormone enters at a low rate, the level of blood pressure decreases as a result of the opening of blood vessels. When hit at a high speed, the force of contractions of the heart also increases, the amount of blood ejected increases and the level of blood pressure rises.

After adrenaline enters the body, it dissolves very quickly and almost completely enters the bloodstream, is processed by the liver and excreted from the body through the kidneys.

Watch a video about the mechanism of action of adrenaline:

When is epinephrine indicated?

Asystole and cardiac arrest are indications for the use of adrenaline

Adrenaline or epinephrine is widely used in medicine. It is used in quite critical situations to remove the human body from a state of shock.

Main uses of epinephrine:

• An acute reaction to an allergen (manifested by edema, rash, shock), which can manifest itself from an insect bite, medication, food, etc.
• as a result of which there is a violation of the blood supply to the most important internal organs
• or serious malfunctions in its work
• Increased asthma or bronchospasm
• Hypoglycemia following insulin overdose
• Increased intraocular pressure (glaucoma)
• After eye surgery (decongestant)
• Abundant hemorrhages of various types (gums, internal and superficial vessels)
• Acute
• Priapism
• Asystole

In addition, epinephrine can be used in the treatment of certain ENT diseases as a vasoconstrictor, which also increases the period of effectiveness of painkillers. With hemorrhoids, suppositories with epinephrine are prescribed to relieve pain and stop bleeding.

In complex surgeries, epinephrine is used to reduce blood loss. In addition, it is an integral part of solutions for local anesthesia to increase their duration. Such solutions are often used in dentistry.

Adrenaline-based tablets are used for the treatment of hypotension and hypertension, as well as for patients with anxiety, fatigue, etc. syndrome.

When is epinephrine contraindicated?

Adrenaline should not be used in atherosclerosis

The use of epinephrine is prohibited:

• Severe (high blood pressure)
• Hypersensitivity to the hormone
• Diabetes
• Pregnancy and lactation
• Pheochromocytomas
• tachyarrhythmia
• Thyrotoxicosis

With extreme caution, you can use epinephrine in the following cases:

• With hypoxia and ventricular arrhythmias
• After
• If you have Parkinson's disease
• If you have Buerger's disease
• With convulsions
• With the development of a state of shock not caused by an allergic reaction
• With metabolic acidosis
• For pulmonary hypertension
• Children and the elderly

It is strictly forbidden to use adrenaline after removing the patient from the state of anesthesia with drugs such as Chloroform, Cyclopropane and Fluorotan due to the high likelihood of a severe one.

How to use adrenaline

Adrenaline is usually given by injection.

Adrenaline is administered to patients as a subcutaneous injection into a vein or muscle, less often with the help of droppers. It is forbidden to put the drug directly into the artery due to the strong narrowing of the peripheral vessels and the high likelihood of developing gangrene.

The dose and type of administration varies depending on the specific situation and the clinical condition of the patient:

• Anaphylactic shock - the hormone is administered as an intravenous injection. The solution is made from 0.1-0.25 mg of the hormone and sodium chloride. With a more stable condition of the patient, it is allowed to increase the dose to 0.3-0.5 mg. It is possible to give a second injection after 10-20 minutes, the next dose after a similar interval.
• Bronchial asthma - an injection of a solution of 0.3-0.5 mg of epinephrine is prescribed, as well as an intravenous injection of a solution of 0.1-0.25 mg of the hormone and sodium chloride. Up to 3 doses are allowed with an interval of 20 minutes.
• To extend the duration of the effect of the anesthetic, 5 μg of adrenaline per 1 ml of the drug is prescribed. For anesthesia in the spinal cord, 0.2-0.4 mg of the hormone is used.
• With extensive hemorrhage, local lotions with adrenaline are used.
• In the case of asystole, intracardiac injections of a solution of the hormone adrenaline and sodium chloride are given at the rate of 0.5 mg per 10 ml. For resuscitation of a person, injections are given into a vein with a break of 3-5 minutes.
• In glaucoma, an adrenaline solution is prescribed in the form of drops for local instillation.

The maximum dosage for an adult patient reaches 1 mg. For children, the dosage reaches 0.5 mg, depending on age.

Adverse reactions

Anxiety, panic, aggression and irritation can be side effects of adrenaline.

Adrenaline can help bring a person out of critical condition and avoid death. But it has a very strong effect on the body. It must be used with great care.

The main effect of adrenaline is manifested in an increase in human performance and concentration. But besides this, side effects are often manifested.

In a situation where a surge of the hormone adrenaline has occurred in the blood, and there is no threat, a person feels a charge of energy and cannot spend it. As a result, he develops anxiety and nervousness.

The most common adverse reactions after the administration of adrenaline:

• Increase or decrease the level
• Heart arythmy
• Headache, dizziness
• Anxiety, panic, aggression, irritation, nervousness
• Memory losses
• Insomnia
• Nausea, vomiting
• Allergic reaction in the form of edema, spasm, rash
• convulsions
• Sometimes, after intramuscular administration of the drug, pain and burning may occur at the injection site.

Overdose

An overdose of adrenaline can lead to cerebral hemorrhage.

The drug should be used with caution and under the supervision of a physician. With prolonged use of epinephrine or overdose when administered, an overdose may occur.

The main signs of an adrenaline overdose are:

• Severe increase in blood pressure
• dilated pupils
• and atria
• Changing cardiac arrhythmia
• Pale skin and icy sweat
• Vomit
• Sudden fears, anxieties
• Headache
• myocardial infarction
• Pulmonary edema
• kidney failure

For a fatal outcome, a dose of 10 ml of a 0.18% solution is sufficient. At the first signs of an overdose, treatment with the drug is stopped. To relieve symptoms, adrenoblockers and fast ones are used. In case of serious consequences of an overdose, a complex restoration of the body is carried out.

Interaction with other drugs

Taking epinephrine with certain medications can harm your heart

The concomitant use of epinephrine with certain medicinal products may cause some reactions depending on the type of combined drug.

Alpha and beta blockers are antagonists of adrenaline, which reduce its activity. In case of an overdose, they are used primarily to relieve symptoms.

Other adrenomimetics enhance the action of adrenaline and contribute to an increase in the manifestation of side effects from its use.

The combined use of adrenaline and cocaine, dopamine and antidepressants may increase the risk of developing arrhythmia. This combination is not allowed or under the strict supervision of doctors.

The combination of epinephrine with sleeping pills, narcotic pain relievers, insulin leads to a decrease in the effectiveness of these drugs.

The combined use of adrenaline with sympathomimetics increases the load on the cardiovascular system and can lead to malfunctions of the heart.

Adrenaline reduces the effectiveness of cholinomimetics, hypoglycemic drugs and antipsychotics.

The effect of adrenaline increases with the simultaneous use of m-anticholinergics, n-anticholinergics, hormonal drugs and MAO inhibitors.

Adrenaline analogs

There are some analogues of epinephrine:

• Adrenalin
• epinephrine hydrotartrate
• Adrenaline hydrotartrate solution for injection 0.18%
• Adrenaline-Hydrochloride-Vial
• Adrenaline tartrate

Adrenaline is an important hormone in the human body. Epinephrine, a synthetically produced drug, is widely used for medical purposes. It helps to restart the work of important organs in case of a threat to human life, increase its efficiency and improve the emotional state.

Epinephrine is a very strong drug that is prescribed in cases of asthma, severe allergic reaction, bleeding, etc. The drug has certain contraindications and side effects. It is used in the form of injections into a muscle or vein and under the strict supervision of doctors.