Drug Therapy Protocols: Adrenaline
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Questions and Answers

What condition is NOT an indication for administering adrenaline (epinephrine)?

  • Shock unresponsive to adequate fluid resuscitation
  • Anaphylaxis
  • Severe life-threatening bronchospasm
  • Hypertension (correct)

    • What is the onset time for intravenous administration of adrenaline (epinephrine)?

  • 5–10 minutes
  • 30 seconds (correct)
  • 2 minutes
  • 60 seconds

    • Which of the following is a common side effect of adrenaline (epinephrine)?

  • Pupil dilation (correct)
  • Anaphylactic shock
  • Bradycardia
  • Silent chest

    • What is the half-life of adrenaline (epinephrine)?

    <p>2 minutes</p> Signup and view all the answers

    In which situation should adrenaline (epinephrine) NOT be administered?

    <p>Stable angina</p> Signup and view all the answers

    What dosage form contains the highest concentration of adrenaline (epinephrine)?

    <p>1 mg/1 mL (1:1,000)</p> Signup and view all the answers

    Which symptom indicates an urgent need for adrenaline (epinephrine) due to severe bronchospasm?

    <p>Silent chest</p> Signup and view all the answers

    What is the primary purpose of adrenaline (epinephrine) administration according to the protocols?

    <p>To ensure a consistent procedural approach to drug administration</p> Signup and view all the answers

    What duration can adrenaline (epinephrine) last after administration via intravenous injection?

    <p>5-10 minutes</p> Signup and view all the answers

    Which population is excluded from the adrenaline (epinephrine) administration protocols?

    <p>No population is specifically excluded</p> Signup and view all the answers

    What classification does adrenaline (epinephrine) fall under?

    <p>Sympathomimetics</p> Signup and view all the answers

    Which condition is a primary indication for administering adrenaline (epinephrine)?

    <p>Severe allergic reactions (anaphylaxis)</p> Signup and view all the answers

    What is a possible side effect of adrenaline (epinephrine) administration?

    <p>Increased heart rate</p> Signup and view all the answers

    What is the primary action of adrenaline on alpha adrenergic receptors?

    <p>Peripheral vasoconstriction</p> Signup and view all the answers

    Which of the following is NOT a primary pharmacological effect of adrenaline?

    <p>Decreased heart rate</p> Signup and view all the answers

    What is the drug class of adrenaline (epinephrine)?

    <p>Sympathomimetic</p> Signup and view all the answers

    In which condition should adrenaline be used with caution due to the risk of hypertension?

    <p>Hypovolaemic shock</p> Signup and view all the answers

    Which enzyme is primarily responsible for the metabolism of adrenaline?

    <p>Monoamine oxidase</p> Signup and view all the answers

    What effect does stimulation of beta-1 adrenergic receptors have?

    <p>Increase in heart rate</p> Signup and view all the answers

    Which of the following is a contraindication for the use of adrenaline?

    <p>Concurrent MAOI therapy</p> Signup and view all the answers

    What is a likely side effect of adrenaline when given in an emergency situation?

    <p>Hypertension</p> Signup and view all the answers

    What is one of the key effects of adrenaline on beta-2 adrenergic receptors?

    <p>Bronchodilation</p> Signup and view all the answers

    In which scenario would adrenaline be most indicated?

    <p>Respiratory distress due to bronchoconstriction</p> Signup and view all the answers

    What is the appropriate paediatric dosage of adrenaline for a child aged 1 year under severe life-threatening bronchospasm?

    <p>150 microg</p> Signup and view all the answers

    Which scenario requires consultation and approval before administering adrenaline?

    <p>Shock unresponsive to fluid resuscitation</p> Signup and view all the answers

    What is the maximum single dose of adrenaline for a child aged less than 6 months?

    <p>50 microg</p> Signup and view all the answers

    How often can adrenaline be repeated for a child with severe bronchospasm?

    <p>Every 5 minutes</p> Signup and view all the answers

    What condition requires a dosage of 5 mg of adrenaline via nebulization?

    <p>Croup (moderate to severe)</p> Signup and view all the answers

    Which of the following indicates a need for intravenous or intraosseous adrenaline administration?

    <p>Haemodynamic compromise</p> Signup and view all the answers

    What is the correct initial IV/IO dosage of adrenaline for a child experiencing shock unresponsive to fluid resuscitation?

    <p>1 microg/kg</p> Signup and view all the answers

    What is a common side effect of adrenaline administration?

    <p>Tachycardia</p> Signup and view all the answers

    In which situation is adrenaline contraindicated?

    <p>Uncontrolled hypertension</p> Signup and view all the answers

    What is the reason for the need to repeat adrenaline doses for bronchospasm?

    <p>To maintain therapeutic effect</p> Signup and view all the answers

    What is the recommended presentation of adrenaline for nebuliser administration?

    <p>1 mg/1 mL (1:1,000)</p> Signup and view all the answers

    Which route of administration is preferred for time-critical adrenaline injections?

    <p>Intramuscular (IM) in the vastus lateralis</p> Signup and view all the answers

    What is the potential side effect of adrenaline after a massive quetiapine overdose?

    <p>Paradoxical hypotension</p> Signup and view all the answers

    Which preparation should be used for low dose IM/IV injections of adrenaline?

    <p>1:10,000 (100 microg/1 mL)</p> Signup and view all the answers

    What should be done before administering treatment outside the listed scope of practice?

    <p>Get mandatory approval via the QAS Clinical Consultation Advice Line</p> Signup and view all the answers

    What is the classification of adrenaline (epinephrine) as a therapeutic substance?

    <p>S3 (therapeutic poison)</p> Signup and view all the answers

    Which of the following statements is true regarding adrenaline infusions?

    <p>They must be administered through an appropriately placed central venous line.</p> Signup and view all the answers

    What alternative medication is suggested for treatment following massive quetiapine overdose?

    <p>Metaraminol</p> Signup and view all the answers

    What is the correct procedure for labeling syringes used for adrenaline administration?

    <p>All syringes must be appropriately labelled.</p> Signup and view all the answers

    Which dosage form should be avoided for nebuliser administration of adrenaline?

    <p>1 mg/10 mL (1:10,000)</p> Signup and view all the answers

    Study Notes

    Drug Therapy Protocols: Adrenaline (epinephrine)

    • Policy code: DTP_ADR_0924
    • Date: September 2024
    • Purpose: Ensures consistent adrenaline administration procedures for Queensland Ambulance Service (QAS) clinical staff.
    • Scope: Applies to QAS clinical staff in pre-hospital settings for all ages, unless specified otherwise.
    • Funding source: 100% internal funding.
    • Author: Clinical Quality & Patient Safety Unit, QAS
    • Review date: September 2026
    • Information security classification: UNCLASSIFIED – Queensland Government Information Security Classification Framework
    • URL: https://ambulance.qld.gov.au/clinical.html
    • Disclaimer: The Digital Clinical Practice Manual is intended for qualified QAS clinicians. QAS disclaims liability related to inaccurate, incomplete, or unavailable materials within the manual.
    • Copyright: This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

    Adrenaline (epinephrine) - Drug Class and Pharmacology

    • Drug class: Sympathomimetic
    • Pharmacology: Primarily acts on alpha (α) and beta (β) adrenergic receptors.
      • Increases heart rate (β1).
      • Increases force of myocardial contraction (β1).
      • Increases ventricular irritability (β1).
      • Causes bronchodilation (β2).
      • Causes peripheral vasoconstriction (α1).
    • Metabolism: Primarily metabolised by sympathetic nerve endings through enzymatic breakdown by monoamine oxidase.

    Indications for Adrenaline Use

    • Cardiac arrest
    • Anaphylaxis
    • Severe life-threatening bronchospasm
    • Silent chest (patients can only speak in single words, or who show haemodynamic compromise, or are altered level of consciousness):
    • Shock unresponsive to fluid resuscitation
    • Bradycardia with poor perfusion (unresponsive to atropine or transcutaneous pacing).
    • Croup (moderate to severe)

    Contraindications, Precautions and Side Effects

    • Contraindications: Hypertension, hypovolemic shock, concurrent MAOI therapy.
    • Precautions: Assess for conditions mentioned in contraindications.
    • Side effects: Anxiety, hypertension, palpitations/tachyarrhythmias, pupil dilation, tremor.

    Adult and Paediatric Dosages and Administration

    • Routes: Intravenous (IV), intramuscular (IM), nebuliser (NEB), intravenous infusion (IV INF), intraosseous (IO), intraosseous infusion (IO INF).
    • Adult dosages: Provided for various conditions (e.g., cardiac arrest, anaphylaxis, severe bronchospasm). Include specific dosages based on administration route, repetition rate, and maximum dosages.
    • Paediatric dosages: Provided for various conditions and specific age groups. Include dosages adjusted for weight.
    • Special notes: Only administer for the listed indications and doses. Any deviation requires QAS Clinical Consultation and Advice. Follow appropriate dilution ratios for solutions and nebulisers. Ensure proper labelling and administration techniques for adrenaline infusions.

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    Drug Therapy Protocols: Adrenaline (Epinephrine) PDF

    Description

    Explore the protocols for administering adrenaline (epinephrine) within the Queensland Ambulance Service. This quiz covers the guidelines intended for clinical staff, detailing the essential procedures and safety measures that must be adhered to in pre-hospital settings. Perfect for QAS clinicians looking to reinforce their knowledge.

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