Adrenaline is one of the most common drugs used for treatment when performing ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support). Another common names for adrenaline is epinephrine. Adrenaline is used during ACLS and PALS because it has a wide range of indications. These include the treatment of cardiac arrest, arrhythmias, and […]
Adrenaline is one of the most common drugs used for treatment when performing ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support). Another common names for adrenaline is epinephrine. Adrenaline is used during ACLS and PALS because it has a wide range of indications. These include the treatment of cardiac arrest, arrhythmias, and extreme allergic reactions such as anaphylaxis.
Adrenaline is a catecholamine having a non-specific action on the adrenoceptors causing an increase in activation of the sympathetic nervous system. Levels of adrenaline can be found endogenously in the body in the adrenal gland. The adrenal gland releases adrenaline in response to stress. The activation of the sympathetic nervous system is commonly referred to as the fight-or-flight response. Adrenaline primarily affects metabolic responses.
Medical Uses of Adrenaline: Cardiac
Medical uses for adrenaline include the treatment of cardiac arrest. Adrenaline primarily increases peripheral vascular resistance or vasoconstriction through the activation of α1receptors and increases cardiac output through β1 receptor activation. This leads to the end result of reduced perfusion of the peripheral extremities in exchange for increased cardiac and cerebral perfusion pressure.
Medical Uses of Adrenaline: Allergies/Anaphylaxis
Adrenaline is also commonly used to treat anaphylactic shock. The primary goal is to reduce the inflammatory response associated with an allergic reaction. In other words to reduce vasodilation caused by the allergic reaction through the stimulation of beta and alpha receptors. This will cause a reduction of fluid leakage through the post capillary venules.
Medical Uses of Adrenaline: Asthma
While adrenaline is no longer used regularly as a first line treatment for asthma it can still provide benefits. Adrenaline acts as a bronchodilator by activating β2 receptors. Generally adrenaline is used if other β2 agonists were ineffective or unavailable for treatment.
Medical Uses of Adrenaline: Local Anesthetics
Adrenaline is used to prolong the affects of local anesthetics by slowing their rate of tissue absorption. This is done through vasoconstriction of local capillaries through the activation of local receptors. Because of the reduced blood flow associated with local adrenaline administration, certain parts of the body should not be injected. This includes distal extremities, genitals, and parts of the face.
Adverse Reactions with Adrenaline
Because of the systemic effects of adrenaline some patients may experience certain unwanted or adverse symptoms associated with its administration. Some of these adverse reactions include anxiety, headache, increased blood pressure, tachycardia, and arrhythmias. Most adverse reactions are dose dependant.
Some feel that the administration of adrenaline has not proven to improve the long-term survival of critically ill patients during cardiac arrest. However, adrenaline remains one of the most commonly used medications in the treatment of cardiac arrest and other arrhythmias during ACLS and PALS administration.