How Effective Is Epinephrine for Asthma?

Adrenaline (adrenaline, epinephrine, English capital abbreviation: A or E) is a hormone secreted by the human body. When a person experiences certain stimuli (such as excitement, fear, tension, etc.) to secrete this chemical, it can make people breathe faster (providing a lot of oxygen), the heartbeat and blood flow are accelerated, the pupils are enlarged, and more energy is provided for physical activity. Make the response faster. Adrenaline is a hormone and neurotransmitter that is released by the adrenal glands. Adrenaline can increase the contractility of the heart, dilate the blood vessels of the heart, liver, and bones, and constrict the blood vessels of the skin and mucous membranes. It is an essential product for saving dying people or animals. Its biosynthesis is mainly the formation of norepinephrine in medulla chromium cells, and then by the action of phenylethanolamine N-methyl transferase (PNMT), the Into adrenaline.

Adrenaline (adrenaline, epinephrine, English capital abbreviation: A or E) is a hormone secreted by the human body. When a person experiences certain stimuli (such as excitement, fear, tension, etc.) to secrete this chemical, it can make people breathe faster (providing a lot of oxygen), the heartbeat and blood flow are accelerated, the pupils are enlarged, and more energy is provided for physical activity. Make the response faster. Adrenaline is a hormone and neurotransmitter that is released by the adrenal glands. Adrenaline can increase the contractility of the heart, dilate the blood vessels of the heart, liver, and bones, and constrict the blood vessels of the skin and mucous membranes. It is an essential product for saving dying people or animals. Its biosynthesis is mainly the formation of norepinephrine in medulla chromium cells, and then by the action of phenylethanolamine N-methyl transferase (PNMT), the Into adrenaline.

The Secret of the Flood Force

At the Rio Olympic Games, Chinese swimmer Fu Yuanhui attracted a large number of fans with her candid and humorous personality. The "flooding power" that she blurted out in an interview was more fun for people. In fact, this power comes from adrenaline.

What is adrenaline more

Adrenaline is a hormone secreted by the adrenal medulla. When the human body experiences certain stimuli, such as excitement and fear, it can secrete this hormone, which accelerates heartbeat and breathing, increases blood flow, and increases blood glucose, thereby increasing strength and increasing response speed. Adrenaline can also be used to save patients with cardiac arrest and anaphylactic shock.

Adrenaline is not elixir more

Adrenaline can only temporarily stimulate people's strength, it does not make people really strong, and it can also cause adverse reactions such as increased blood pressure and arrhythmia. In addition, adrenaline can interact with many drugs and cause damage to the human body.

Content finishing:

Drug Name

Epinephrine

Alias

Accessory kidney

Foreign name

adrenaline, epinephrine, A, E

Whether prescription drugs

prescription

Main indications

Can alleviate weak heartbeat, decreased blood pressure, difficulty breathing, etc.

Dosage

Subcutaneous injection or intramuscular injection 0.5 1mg

Adverse reactions

Pale, tachycardia, increased alertness, etc.

Main medication contraindications

Children, the elderly, patients with organic brain damage, and pregnant women

Dosage form

0.5ml each: 0.5mg, 1ml: 1mg; solution 0.1%

Athletes use with caution

Use with caution

Whether to include health insurance

Not included

Drug type

hormone

Introduction to adrenaline compounds

Adrenaline Basic Information

Scale model

Chinese name: adrenaline

Chinese alias: adrenaline tartrate; L-3,4-dihydroxy--((methylamino) methyl) benzyl alcohol D-tartrate;

English name: epinephrine hydrogen tartrate
(-) Epinephrine-(+)-hydro

English alias: (-)-Epinephrine-(+)-Hydrogentartrate; (-)-adrenalinehydrogentartrate; L-(-)-Epinephrine-(+)-bitartrate; (? -Epinephrine (+) bitartratesalt; EpinephrineBitartrate; Adrenalinetartrate; Epinephrine Acid Tartrate; 4-[(1S) -1-hydroxy-2- (methylamino) ethyl]; 4-[(1R) -1-hydroxy-2- (methylamino) ethyl] benzene-1,2-diol 2,3- dihydroxybutanedioate (salt); Adrenaline

CAS number: 51-42-3

Adrenaline structure

EINECS number: 200-097-1

Molecular formula: C ₉ H ₁₃ O ₃ N

Molecular weight: 183.204

InChI: InChI = 1 / C9H13NO3.C4H6O6 / c1-10-5-9 (13) 6-2-3-7 (11) 8 (12) 4-6; 5-1 (3 (7) 8) 2 ( 6) 4 (9) 10 / h2-4,9-13H, 5H2,1H3; 1-2,5-6H, (H, 7,8) (H, 9,10)

Adrenaline physicochemical properties

Boiling point: 413.1 ° C at 760 mmHg

Flash point: 207.9 ° C

Epinephrine injection

Vapor pressure: 1.45E-07mmHg at 25 ° C

Adrenaline use

Mainly used for the rescue of dangerous goods signs of anaphylactic shock, bronchial asthma and cardiac arrest:

Risk term: R28:; R36 / 37/38 :;

Security term: S26:; S28:; S36 / 37:; S45 :;

Adrenaline Pharmacopoeia Standard

Adrenaline source (name), content (potency)

This product is (R) -4- (2- (methylamino) -1-hydroxyethyl] -1,2-benzenediol. Based on the dried product, the content of C9H13NO3 should not be less than 98.5%.

Adrenaline traits

This product is white or off-white crystalline powder; odorless and bitter; it is susceptible to oxidative deterioration when exposed to air or sunlight; it is unstable in neutral or alkaline aqueous solutions; saturated aqueous solutions show weak alkaline reactions.

This product is very slightly soluble in water, insoluble in ethanol, chloroform, ether, fatty oil or volatile oil; easily soluble in inorganic acid or sodium hydroxide solution, insoluble in ammonia solution or sodium carbonate solution.

Adrenaline melting point

This product has a melting point (Appendix VI C to Part II of the 2010 Pharmacopoeia) of 206 to 212 ° C. It decomposes simultaneously when melted.

Adrenaline specific rotation

Take this product, accurately weigh it, add hydrochloric acid solution (9 200) to dissolve and quantitatively dilute it to make a solution containing 20mg per 1ml, and measure it according to law (Appendix VI E of the Pharmacopoeia Part II of 2010 Edition), with a specific rotation of -50.0 ° To -53.5 °.

Adrenaline identification

(1) Take about 2mg of this product, add 2 ~ 3 drops of hydrochloric acid solution (9 1000) to dissolve, add 2 drops of water and 1 drop of ferric chloride test solution, it will become emerald green; add 1 drop of ammonia test solution, It turns purple and finally turns mauve.

(2) Take 10mg of this product, add 2ml of hydrochloric acid solution (9 1000) to dissolve, add 10 drops of hydrogen peroxide test solution, and boil, it will show blood red.

Epinephrine test

1 Clarity and color of acid solution

Take the solution under the specific rotation to check, and it should be clear and colorless; if the color is developed, compare with the same volume of the control solution (take the yellow color standard solution 3 or orange red standard color solution 5ml and water 5ml) (2010 Appendix A of the Pharmacopoeia of the Year Edition A first method), must not be deeper.

2 Ketone bodies

Take this product, add hydrochloric acid solution (9 2000) to make a solution containing 2.0mg per 1ml, and measure it at a wavelength of 310nm according to the ultraviolet-visible spectrophotometry (Appendix IV A of Pharmacopoeia Part II of the 2010 edition) Over 0.05.

3 Related substances

Take about 10mg of this product, weigh it accurately, put it in a 10ml measuring bottle, add 0.1ml of hydrochloric acid to dissolve it, dilute to the mark with mobile phase, shake well, and use it as the test solution; take 1ml of test solution precisely and place it in 500ml In a measuring flask, dilute to the mark with mobile phase and shake well as a control solution; take another 50mg of this product and place it in a 50ml measuring flask, add 1ml of concentrated hydrogen peroxide solution, leave it overnight, add 0.5ml of hydrochloric acid, add mobile phase to dilute To the mark, shake well, as an oxidative damage solution; take an appropriate amount of norepinephrine tartrate reference solution, add the oxidative damage solution to dissolve and dilute to make a solution containing 20 g per 1 ml, and use it as a system suitability test solution. According to the high-performance liquid chromatography (2010 edition Pharmacopoeia Part II Appendix V D) test, use octadecylsilane bonded silica as a filler; use tetramethylammonium hydrogen sulfate solution (take 4.0g of tetramethylammonium hydrogen sulfate, 1.1 g of sodium heptane sulfonate, 2 ml of 0.1 mol / L ethylenediamine tetraacetic acid disodium solution, dissolved in water and diluted to 950 ml)-methanol (95: 5) (adjust the pH to 3.5 with 1 mol / L sodium hydroxide solution) ) Is the mobile phase; the flow rate is 2 ml per minute, and the detection wavelength is 205 nm. Take 20l of the system suitability test solution and inject it into the liquid chromatograph. There should be two unknown impurity peaks between the norepinephrine peak and the epinephrine peak. The theoretical number of plates should be no less than 3000 based on the norepinephrine peak. The resolution of the prime peak, the adrenaline peak and the adjacent impurity peaks should all meet the requirements. Take 20l of the control solution, inject it into the liquid chromatograph, adjust the detection sensitivity so that the peak height of the main component chromatographic peak is about 20% of the full range, and then accurately measure 20l each of the test solution and the control solution, and inject them into the liquid chromatography. Instrument, record the chromatogram. If there is an impurity peak in the chromatogram of the test solution, the area of a single impurity peak must not be larger than the main peak area of the control solution (0.2%), and the sum of the area of each impurity peak must not be greater than 2.5 times (0.5%) the main peak area of the control solution.

4 Loss on drying

Take this product and put it in a phosphorus pentoxide dryer and dry it under reduced pressure for 18 hours. The weight loss should not exceed 1.0% (Appendix L of the Pharmacopoeia Part II of the 2010 edition).

5 Ignition residue

Must not exceed 0.1% (Appendix N of Part Two of the 2010 Pharmacopoeia).

Adrenaline determination

Take about 0.15g of this product, accurately weigh, add 10ml of glacial acetic acid, shake and dissolve, add 1 drop of crystal violet indicator solution, titrate with perchloric acid titrant (0.1mol / L) until the solution is blue-green, and The results of the titrations are corrected with a blank test. Each 1ml of perchloric acid titration solution (0.1mol / L) is equivalent to 18.32mg of C ₉ H ₁₃ O ₃ N ^[1] .

Epinephrine category

Adrenaline receptor agonist.

Adrenaline storage

Shaded, sealed under reduced pressure, stored in a cool place.

Epinephrine preparation

Epinephrine hydrochloride injection

Epinephrine drug description

Epinephrine classification

Circulatory Drugs> Antiarrhythmic Drugs> Treatment of Bradycardia

Epinephrine dosage form

1. Injection: a sterile solution of epinephrine hydrochloride or epinephrine tartrate, containing 1 mg of epinephrine and 8 mg of sodium chloride per milliliter. 1mg (ml), 0.5mg (0.5ml);

2. Oil injection: 2mg (1ml) (for intramuscular injection only).

3. Eye drops: 0.1%, 0.5%, 2%.

Epinephrine pharmacological effects

Epinephrine directly excites the adrenaline and receptors. By exciting the bronchial smooth muscle 2 receptors, it can relieve bronchospasm, relax the bronchi, improve the ventilation function, and inhibit the release of allergic mediators, produce asthma effects, and also inhibit the endothelial permeability Sexual increase, promote mucus secretion and cilia movement, promote alveolar type cells synthesis and secretion of surfactants. At the same time, the alpha receptors in the bronchial mucosa are excited, causing excessive contraction of the mucosal blood vessels and increased capillary pressure, which may lead to increased mucosal edema and hyperemia and weaken the asthma effect. Cardiovascular 1 receptor excitement can strengthen myocardial contractility, increase heart rate, and increase cardiac output. In addition, there are still effects of increasing basal metabolism, raising blood sugar and dilated pupils. Its bronchodilator effect is strong and rapid, but relatively short. Subcutaneous injection of 0.25 to 0.5 mg, which takes effect for 10 to 15 minutes, and maintains the effect for 1 to 2 hours. Because of its many adverse reactions, it has rarely been used as an asthma treatment in clinical practice, and is only used in severe bronchial asthma, especially in the acute attack of allergic asthma. Inhaled by a quantitative aerosol, the bronchodilator effect is weak and transient.

Epinephrine pharmacokinetics

Little oral absorption. After oral administration, the local vascular contraction of the digestive tract reduces absorption, and the absorbed part can be rapidly degraded by the enzyme in the gastrointestinal tract and metabolized in the liver. It cannot reach an effective concentration, so oral administration is not effective. It is effective 3 to 5 minutes after subcutaneous injection, and the effect can be maintained for about 1 hour. Because the subcutaneous blood vessels can be contracted, the maintenance time is longer, and the absorption is delayed, it is generally appropriate to use subcutaneous injection. Intramuscular injection absorbs quickly and has a strong effect, but only lasts for 10-30 minutes. After injection, it is rapidly metabolized and inactivated by catechol oxygen methyltransferase (COMT) and monoamine oxidase (MAO) in blood and tissues. The metabolite 4-hydroxy-3-methoxymandelic acid Excreted mainly by urine.

Epinephrine

Adrenaline use

This product directly acts on adrenergic and receptors, and produces strong and rapid and short-term excitation of and -type effects. Excitation of cardiac 1-receptors can increase myocardial contractility, increase heart rate and myocardial oxygen consumption increase. At the same time, it acts on vascular smooth muscle 2-receptors, which dilates blood vessels, reduces peripheral vascular resistance and reduces diastolic blood pressure. Exciting 2-receptors can relax bronchial smooth muscles, dilate the bronchi, and relieve bronchospasm. Exciting -receptors can shrink the skin, mucosal blood vessels, and small visceral vessels. It is mainly used for cardiac arrest, bronchial asthma, anaphylactic shock, and can also treat urticaria, hay fever, and nasal mucosa or gum bleeding.

Physiological effect

Adrenaline generally increases the contractility of the heart; blood vessels in the heart, liver, and bones dilate and blood vessels in the skin and mucous membranes shrink. In medicine, epinephrine is used to stimulate the heart when the heart is stopped, or to dilate the trachea when asthma. It has a contraction effect on the blood vessels of the skin, mucous membranes and internal organs (such as the kidneys); it has a dilation effect on the coronary arteries and skeletal muscle blood vessels. Because it can directly act on coronary vessels to cause vasodilation and improve heart blood supply. Utilizing its effects of exciting heart contraction blood vessels and relaxing bronchial smooth muscles, it can relieve symptoms such as weak heartbeat, decreased blood pressure, and difficulty breathing. Adrenaline can stimulate both alpha and beta receptors, producing strong alpha and beta effects.

The heart acts on the 1 receptors of the myocardium, the conduction system, and the sinoatrial node, strengthening myocardial contractility, accelerating conduction, accelerating heart rate, and increasing myocardial excitability. The effect on isolated myocardium is characterized by an accelerated rate of contractile development (positive contractile effect).

Clinical application

Rescue for cardiac arrest and anaphylactic shock can also be used for the treatment of other allergic diseases (such as bronchial asthma, urticaria). Combination with local anesthetics is beneficial for local hemostasis and prolonged efficacy.

Adrenaline indication

1. Early epinephrine solution eye-dropping is used to treat primary open-angle glaucoma and secondary open-angle glaucoma. The mechanism of lowering intraocular pressure is not fully understood, and it is considered to be related to reducing the secretion of aqueous humor and improving the coefficient of aqueous humor . Adrenaline has a lower therapeutic index for reducing intraocular pressure. The effect of reducing intraocular pressure is proportional to its concentration. However, the increase in concentration is accompanied by the increase of side effects caused by systemic absorption. Therefore, it has rarely been applied to the treatment of glaucoma.

2. Mydriasis: It often uses its dilation effect and cocaine and atropine to form a dilated pupil mixture to maximize the dilation effect to combat iris adhesion and is used to treat iris inflammation and eye trauma. It can also be used in combination with miotic agents in the treatment of glaucoma to prevent post-iris adhesions and pupil sphincter spasm and pupil block, and reduce the side effects of long-term pupil dilation.

3. Vasoconstrictive effect: Utilizing its vasoconstrictive effect, using solution drops to constrict the bulbar conjunctival vessels can identify bulbar conjunctival congestion and ciliary congestion and scleral congestion; external or intraoperative surgery can reduce bleeding in the surgical field, but It is not effective for larger blood vessels; adding a small amount of epinephrine to a local anesthetic can prolong the action time of local anesthetics, reduce the amount of local anesthetics, and reduce its systemic absorption ^[2] .

Adrenaline contraindications

1. It can temporarily increase the symptoms of stiffness and tremor.

2. Hypotension caused by chlorpromazine and phentolamine, and anaesthesia with chloroform and cyclopropane are contraindicated.

Epinephrine dosage

1. Commonly used to rescue anaphylactic shock, such as anaphylactic shock caused by penicillin. As the product has the effects of exciting myocardium, increasing hypertension, relaxing bronchial smooth muscle, etc., it can relieve symptoms of weak heartbeat, decreased blood pressure, and difficulty breathing in anaphylactic shock. Subcutaneous injection or intramuscular injection of 0.5 to 1 mg, can also be used for slow intravenous injection of 0.1 to 0.5 mg (diluted to 10 ml with isotonic saline), if the effect is not good, you can use 4 to 8 mg intravenously (soluble 5% glucose solution 500 1000ml).

2. Rescue cardiac arrest; can be used for cardiac arrest caused by anesthesia and accidents caused by surgery, drug poisoning or cardiac block, etc. Intracardial injection with 0.25 0.5mg, and also for cardiac massage, artificial breathing and Correct acidemia. For sudden cardiac arrest caused by electric shock, this product can also be used in conjunction with an electric defibrillator or lidocaine for rescue.

3 Treatment of bronchial asthma: rapid but not lasting. Subcutaneous injection of 0.25 to 0.5 mg, effective after 3 to 5 minutes, but only for 1 hour. Repeat the injection once if necessary.

4 Combined with local anesthetics: Adding a small amount (about 1: 200,000 to 500,000) to local anesthetics (such as procaine) can reduce the absorption of local anesthetics, prolong their efficacy, and reduce their toxic and side effects. Reduce bleeding at the surgical site.

5. Stop bleeding from the nasal mucosa and gums: Fill the bleeding area with gauze soaked with a solution (1: 2 million to 1: 1000).

6. Treatment of urticaria, hay fever, serum reaction, etc .: Subcutaneous injection of 1: 1000 solution 0.2 ~ 0.5ml, if necessary, inject once more at the above dose.

Injection dose

The commonly used amount is 0.25 mg to 1 mg once per subcutaneous or intramuscular injection.

1. For cardiac arrest, 0.5 mg to 1.0 mg, or 0.01 to 0.02 mg / kg of epinephrine is diluted with 10 ml of physiological saline for injection, or injected directly into the left apex. Five minutes later, depending on the condition, the drug can be re-administered, and at the same time, the heart press , Artificial respiration and other auxiliary measures to correct acidemia.

2. Bronchial asthma is injected subcutaneously from 0.25 to 0.5 mg, and can be repeated if necessary.

3 Allergic diseases are injected subcutaneously or intramuscularly from 0.3mg to 0.5mg (0.1% injection of 0.3ml to 0.5ml). When used for anaphylactic shock, the product can also be 0.1mg 0.5mg diluted with physiological saline and then slowly injected intravenously or 4mg 8mg of this product can be added to 500ml 1000ml physiological saline for intravenous drip.

4 In combination with local anesthetics, add a small amount (about 1: 500 000 to 200,000) in local anesthetics (procaine), and the total amount should not exceed 0.3 mg.

5. For local mucosal hemostasis, immerse the gauze with the solution (1:20 000-1 000) to fill the bleeding site.

Adrenaline adverse reactions

1. Systemic reactions: sometimes anxiety, paleness, insomnia, fear, dizziness, headache, vomiting, sweating, cold limbs, tremors, weakness, palpitations, elevated blood pressure, urinary retention, bronchi and pulmonary edema, short-term Elevated blood lactate or blood sugar. Large doses of excitatory centers cause agitation, vomiting, muscle rigidity, and even convulsions. When the dosage is too large or the subcutaneous injection is mistakenly injected into the vein, it can cause sudden rise in blood pressure and arrhythmia. In severe cases, it can develop into cerebral hemorrhage and ventricular fibrillation.

2. Ocular reactions: temporary stinging or burning sensation in the eyes, tearing, eyebrow arch pain, headache, allergies, scleritis; long-term application can cause eyelids, combined membrane and corneal melanin deposition, corneal edema, etc.

Adrenaline drug interactions

1. Digitalis or general anesthetic can increase the sensitivity of myocardium to adrenaline. This product combined with the above drugs can cause arrhythmias and even ventricular fibrillation.

2. Combined with oxytocin drugs such as oxytocin and ergometrine, it can enhance vasoconstriction and cause hypertension or peripheral tissue ischemia.

3 Combined with nitrate drugs, it can cause hypotension, and the antianginal effect of nitrate drugs is weakened.

4 Combined with ephedrine, it has a synergistic effect on the contraction of peripheral arterioles, causing a sharp rise in blood pressure and arrhythmia in asthma patients. Not suitable for use.

5. Used in combination with hypoglycemic agents to reduce the hypoglycemic effect of the latter.

6. -receptor blockers can antagonize the bronchiectasis and vasoconstrictive effects of this product, and should be used with caution.

7. Tricyclic antidepressants can enhance the cardiovascular effects of the product, leading to arrhythmia, hypertension or tachycardia.

8. In combination with guanethidine and reserpine, the effect of this product is enhanced, resulting in hypertension and tachycardia, while the antihypertensive effect of guanethidine and reserpine is weakened.

9. Compatible with alkaline drugs. Changes in the properties of medicines are prohibited.

10 Combined with alpha receptor blockers, can cause severe hypotension. Fast-acting vasodilators and a-receptor blockers can combat the dramatic boosting effects caused by large doses of this product.

11. Shock caused by procaine, if rescued with this product, can cause ventricular fibrillation.

12. When using chloroform, chloroethane and halothane for anesthesia, the product is prohibited. So as not to increase myocardial emergencies and cause severe arrhythmias.

13. It is used in combination with isoproterenol, norepinephrine (triple solution) or atropine to form a quadruple solution, which can be used for cardiac resuscitation with good results.

14. Used in combination with gray pressure sensitivity, it has a synergistic vasodilation effect, and the excitatory effect on the heart is also enhanced.

15. With phenothiazines, severe shock can result.

16. Combined with thyroid hormone, it can significantly increase blood pressure and induce cardiovascular accidents.

17. When diuretics reduce blood volume and blood sodium, it can reduce the pressurizing effect of the product.

Adrenaline notes

1

1. (1) In the case of insufficient circulation capacity or hypotension caused by phenothiazines, the use of epinephrine can lead to further decline in blood pressure and should be used with caution; (2) Coronary artery disease.

2. The effects of drugs on the elderly: The elderly are more sensitive to the effects of sympathomimetic drugs.

3. The effects of drugs on pregnancy: (1) in animal studies, when the dose is 25 times higher than the maximum dose of humans, it has teratogenic effects; (2) adrenaline can pass through the placental barrier, causing fetal hypoxia, and Relax uterine smooth muscles and prolong the second stage of labor. Large doses can reduce uterine contractions, so it is not recommended for delivery. (3) Adrenaline is used to maintain blood pressure during cesarean anesthesia, which can accelerate fetal heartbeat. When the maternal blood pressure exceeds 17.3 / Not suitable for 10.7kPa (130 / 80mmHg).

4. The effects of drugs on breastfeeding: (not yet clear) 5. The effects of drugs on test values or diagnosis: blood glucose and serum lactic acid levels may increase when epinephrine is used.

6. Check and monitor before and after the medication and when taking the medication: When using epinephrine injection, you must pay close attention to changes in blood pressure, heart rate, and rhythm, and you must measure blood glucose changes when you use it multiple times. Long-term or excessive use can cause drug resistance, and the drug can be recovered after a few days of discontinuation.

8. Adrenaline injection with a concentration of 1: 1000 (1ml / ml) must be diluted before intracardiac or intravenous injection. Intra-arterial injection is not recommended because it can cause severe vasoconstriction and tissue necrosis.

9. Repeated administration at the same site can cause tissue necrosis, and the injection site must be rotated.

10. When used for anaphylactic shock, due to increased permeability of blood vessels, the effective blood volume is insufficient, and blood volume must be replenished at the same time.

11. Adrenaline can decompose and change color when exposed to oxides, alkalis, light and heat. Its aqueous solution will decompose and turn red when exposed to air and light. It is not suitable for use.

12. The dose of the drug must be strictly controlled during use, and the intravenous injection should be slowly administered after dilution.

13. When using epinephrine eye drops, it should be taken at least 5 minutes after the use of the migraine to avoid frontal pain or headache.

14. Digitalis can increase the sensitivity of myocardium to epinephrine, so patients with digitalis should be careful when applying adrenaline.

15. It is contraindicated in physical compatibility with warfarin, hyaluronidase and new mold.

16. The signs of overdose are: anxiety, flushing of the skin, chest pain, chills, convulsions, changes in blood pressure, arrhythmia, nausea, vomiting, pale and cold skin.

17. The following reactions should be noted when they persist: headache, anxiety, irritability, insomnia, pale, fear, tremor, dizziness, sweating, abnormally fast heartbeat or heavy feeling ^[2] .

Epinephrine overdose

Misuse of epinephrine can cause nausea, vomiting, pale, tachycardia, chest pressure, premature ventricular beat, increased blood pressure, muscle tremor, unstable gait, chills, fever, sweating, and dilated pupil , Wheezing breathing, convulsions, etc. When blood pressure rises sharply, there is a throbbing headache. Severely ill children often develop pulmonary edema, ventricular fibrillation, cerebral hemorrhage, coma, and paralysis of the heart and respiratory center.

Rescue of adrenaline poisoning

Adrenaline inhibits blockers, which can quickly lower blood pressure and prevent arrhythmias. Commonly used are:

1. Benzylamine 0.52mg / kg plus 250ml saline, intravenous drip

2. Hydrogen ergot base 0.3-1mg, intramuscularly or intravenously

3.Piperoxan 10-20mg intravenous injection

4. Immediately inhale 0.2m1 of isoamyl nitrite, or 0.6-1.2mg of nitroglycerin, sublingually, add 0.25g of chlorotheophylline to 20m1 of 25% glucose solution, and inject intravenously.

5. Oxygen

6. Symptomatic treatment

Adrenaline production unit

Chongqing Dikang Changjiang Pharmaceutical Co., Ltd.

Hangzhou Minsheng Pharmaceutical Group Co., Ltd.

Kunming Pharmaceutical Group Co., Ltd.

Hainan Lingkang Pharmaceutical Co., Ltd.

Tianjin Jinyao Amino Acid Co., Ltd.

Shanghai Pharmaceutical (Group) Co., Ltd. Xinyi Pharmaceutical General Factory

Shanghai Hefeng Pharmaceutical Co., Ltd.

Xi'an Lijun Pharmaceutical Co., Ltd.

Shaanxi Jingxi Pharmaceutical Co., Ltd.

Shanxi Weiqida Pharmaceutical Co., Ltd.

Datong Huida Pharmaceutical Co., Ltd.

Wuhan Grand Pharmaceutical Group

Adrenaline release

It is used to regulate myocardium, increase hypertension, activate sympathetic nerves, transport glucose to muscles, and promote muscle activity to cope with stress or danger. It can instantly give people powerful functions to boost and horrific explosive power, but if the secretion is too high than the body Tolerable limit, it will make the pores and blood vessels tighten, and even block the adverse effects of transporting blood to the heart, palpitations, headaches, agitation, nausea or physical disturbances.

Adrenaline Expert Reviews

Due to the many adverse effects of epinephrine, it is rarely used as an asthma drug in clinical practice. Epinephrine is an adrenaline (, ) agonist. For clinical cardiac resuscitation, anaphylactic shock, and cardiac arrest, adrenaline is generally preferred. Can excite myocardium, increase hypertension, and quickly relieve symptoms. Use of commonly used doses can increase systolic blood pressure and diastole increases as doses increase. Epinephrine also relaxes the bronchial smooth muscles, dilates the bronchi, and relieves bronchospasm. Therefore, the clinical application of bronchial asthma is significant. Epinephrine can excite both the alpha receptor and the beta receptor, shrink the blood vessels, enlarge the pupils, reduce the production of aqueous humor, make the aqueous humor drain easily, and reduce the intraocular pressure. The effect of reducing intraocular pressure is directly proportional to its concentration, but the increase in concentration is accompanied by an increase in adverse reactions caused by systemic absorption. Therefore, it has rarely been used in the treatment of glaucoma clinically ^[2] .