Pharmacology
Respiratory
Which of the following is NOT an effect of adrenaline:
Answer:
Adrenaline is a catecholamine that acts on both alpha and beta receptors and increases both heart rate and contractility (beta1 effects); it can cause peripheral vasodilation (a beta2 effect) or vasoconstriction (an alpha effect). Adrenaline causes mydriasis and reduces pressure in open-angle glaucoma.Adrenaline Therapy
Pharmacology / Respiratory
Last Updated: 3rd April 2019
Adrenaline is a catecholamine that acts on both alpha and beta receptors and increases both heart rate and contractility (beta1 effects); it can cause peripheral vasodilation (a beta2 effect) or vasoconstriction (an alpha effect).
Adrenaline is used in cardiopulmonary resuscitation, in the emergency management of acute allergic and anaphylactic reactions and in the management of severe croup (as a nebuliser solution).
Mechanism of Action in Anaphylaxis
As an alpha-receptor agonist, adrenaline reverses peripheral vasodilation and increased vascular permeability reducing hypotension and oedema.
As a beta-receptor agonist it dilates bronchial airways, increases the force and rate of myocardial contraction, and suppresses histamine and leukotriene release.
Adrenaline also alleviates pruritus, urticaria, and angioedema and may relieve gastrointestinal and genitourinary symptoms associated with anaphylaxis because of its relaxer effects on the smooth muscle of the stomach, intestine, uterus and urinary bladder.
Adrenaline increases glycogenolysis, reduces glucose uptake by tissues, and inhibits insulin release in the pancreas, resulting in hyperglycemia and increased blood lactic acid.
Interactions
Severe anaphylaxis in patients taking beta-blockers may not respond to adrenaline—consider bronchodilator therapy. Furthermore, adrenaline can cause severe hypertension and bradycardia in those taking non-cardioselective beta-blockers.
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
