ADRENALINE AGUETTANT 0.1 mg/ml Injection/Solution for

What is ADRENALINE AGUETTANT 0.1 mg/ml

• Pharmaceutical identity. ADRENALINE AGUETTANT is a sterile, preservative-free solution containing adrenaline (epinephrine) acid tartrate 0.1 mg per mL (1:10 000), supplied in 10 mL polypropylene pre-filled syringes ready for immediate use in critical care settings.

• Therapeutic class. It is a direct-acting sympathomimetic catecholamine classified as a non-selective adrenergic agonist (ATC code C01CA24), exerting potent α- and β-adrenergic effects pivotal in cardiovascular resuscitation.

• Primary indications. The preparation is formulated for: advanced cardiac life support (ACLS) during cardiopulmonary resuscitation; management of profound hypotension or septic shock unresponsive to volume therapy; temporary support in complete heart block prior to pacing; and adjunctive treatment of anaphylaxis when intravenous access is established and intramuscular epinephrine (1 mg/mL) has failed.

• Presentation advantages. Pre-filled syringes eliminate dilution errors, speed drug delivery, and minimize contamination risk—key factors when seconds decide neurological outcomes.

• Regulatory status. Licensed as an emergency medicine on hospital crash carts and in ambulances. Because it is life-saving, it is listed on the WHO Model List of Essential Medicines.

• Professional oversight. Use is restricted to physicians, paramedics, or nurses trained in advanced resuscitation, as inappropriate dosing can precipitate severe arrhythmias or cerebrovascular catastrophe.

How to use ADRENALINE AGUETTANT 0.1 mg/ml

• Check and prepare. Verify the syringe’s integrity, expiry date, and solution clarity. Attach a Luer-lock connector; purge air to ensure an exact 10 mL (1 mg) dose.

• Administration routes. Designed for intravenous bolus or intra-osseous injection during CPR; may be used for controlled continuous i.v. infusion via syringe pump (dilute further in 0.9 % saline or 5 % dextrose) for shock.

• Bolus technique (ACLS). Inject the full 10 mL (1 mg) rapidly through the most proximal IV line followed by a 20 mL saline flush to propel the drug into the central circulation; resume chest compressions immediately to augment myocardial perfusion.

• Infusion set-up. For refractory septic or cardiogenic shock, commence at 0.05–0.1 µg/kg/min, titrating every 2–3 min to mean arterial pressure ≥ 65 mmHg while monitoring invasive blood pressure and lactate.

• Emergency anaphylaxis (IV route). If life-threatening airway or circulatory collapse persists after intramuscular epinephrine 0.5 mg (1 mg/mL), give 50–100 µg slow IV push (0.5–1 mL of this solution) over 1 min under cardiac monitoring.

• Safety checks. Continuously monitor ECG, SpO₂, end-tidal CO₂, and blood pressure; have defibrillation and anti-arrhythmic drugs at hand. Document time, dose, and patient response in the code sheet.

Mode of Action ADRENALINE AGUETTANT 0.1 mg/ml

• α₁ receptor stimulation. Causes rapid peripheral vasoconstriction, elevating systemic vascular resistance and diastolic pressure, thereby improving coronary and cerebral perfusion during low-flow states.

• β₁ receptor stimulation. Increases heart-rate (positive chronotropy) and myocardial contractility (positive inotropy), heightening cardiac output essential for return of spontaneous circulation (ROSC).

• β₂ receptor effects. Induces bronchial smooth-muscle relaxation and mast-cell stabilization, counteracting airway edema and mediator release in anaphylaxis.

• Metabolic actions. Activates hepatic glycogenolysis and lipolysis, raising plasma glucose and free fatty acids—an energy supply during stress but a risk in hyperglycemic states.

• Rapid onset and short half-life. Clinical effects begin within seconds IV; plasma t_1/2 ≈ 2–3 min due to hepatic/neuronal COMT and MAO metabolism, necessitating repeated boluses or continuous infusion.

• Pharmacodynamic synergy. Vasoconstriction funnels limited preload to vital organs, while β-effects enhance pump function; together they restore perfusion pressures that CPR alone rarely achieves.

ADRENALINE AGUETTANT 0.1 mg/ml Interactions ADRENALINE AGUETTANT 0.1 mg/ml

• Non-selective β-blockers (e.g., propranolol). Antagonize β-mediated bronchodilation yet leave unopposed α-vasoconstriction, precipitating severe hypertension and reflex bradycardia.

• MAO inhibitors & tricyclic antidepressants. Inhibit catecholamine breakdown and neuronal reuptake; even low doses of adrenaline can evoke hypertensive crisis or arrhythmias. Withhold elective adrenaline for 14 days after MAOi discontinuation.

• Volatile halogenated anaesthetics (e.g., sevoflurane). Sensitize myocardium to catecholamines; combined use increases risk of ventricular tachycardia or fibrillation—limit cumulative dose < 3 µg/kg in such settings.

• Digitalis glycosides. Additive pro-arrhythmic effects; monitor potassium levels and avoid concurrent intravenous boluses if recent digoxin therapy.

• Sodium bicarbonate. Direct admixture in the same line causes pH-dependent oxidation and inactivation of adrenaline; flush thoroughly or use a separate lumen.

• Ergot alkaloids & oxytocic agents. Synergistic vasoconstriction can trigger peripheral or uterine ischemia. Observe limb perfusion and uterine tone when co-administered postpartum.

Dosage of ADRENALINE AGUETTANT 0.1 mg/ml

• Adults—cardiac arrest: 1 mg (10 mL) IV/IO every 3–5 minutes during CPR. Consider reduced 0.5 mg in low body-weight or prolonged downtime to mitigate post-ROSC vasoconstriction.

• Pediatrics—cardiac arrest: 0.01 mg/kg (0.1 mL/kg) IV/IO (maximum 1 mg) every 3–5 minutes.

• Anaphylaxis (IV rescue): 50 µg adult bolus (0.5 mL) over ≥ 1 minute; repeat twice at 5-minute intervals if hypotension persists, then commence infusion 0.05–0.1 µg/kg/min.

• Septic or cardiogenic shock: Start 0.05 µg/kg/min IV infusion; titrate by 0.02–0.05 µg/kg/min increments q5 min to achieve target MAP. Maximum commonly 2 µg/kg/min, though higher doses are documented.

• Neonatal resuscitation: 0.01–0.03 mg/kg IV/IO bolus (0.1–0.3 mL/kg) every 3-5 min if heart-rate < 60 bpm despite ventilation and compressions.

• Renal or hepatic impairment: No dosing adjustment; however, intensified hemodynamic and metabolic monitoring is mandatory as clearance may be delayed in severe organ dysfunction.

Possible side effects of ADRENALINE AGUETTANT 0.1 mg/ml

• Cardiovascular. Tachyarrhythmias (atrial fibrillation, ventricular tachycardia), severe hypertension, myocardial ischemia, pulseless electrical activity (high doses), and paradoxical bradycardia after reflex vagal activation.

• CNS. Anxiety, tremor, headache, confusion, and rarely intracerebral hemorrhage when hypertensive surges exceed autoregulatory capacity.

• Respiratory. Pulmonary edema may follow massive β₁-mediated afterload elevation, especially in elderly or those with left-ventricular dysfunction.

• Metabolic. Transient hyperglycemia, lactic acidosis (type B), hypokalemia, and metabolic acidosis from increased glycolysis.

• Local tissue injury. Extravasation causes intense vasoconstriction leading to blanching, necrosis, or compartment syndrome; treat promptly with phentolamine infiltration.

• Hypersensitivity. True allergic reactions to the tartrate salt or latex syringe components are exceedingly rare but manifest as rash, bronchospasm, or anaphylactoid events.

ADRENALINE AGUETTANT 0.1 mg/ml Contraindications ADRENALINE AGUETTANT 0.1 mg/ml

• No absolute contraindication exists when the drug is required for cardiac arrest or life-threatening anaphylaxis; benefit unequivocally outweighs risk.

• Relative contraindications. Uncontrolled hypertension, active myocardial ischemia, obstructive hypertrophic cardiomyopathy, hyperthyroidism, and narrow-angle glaucoma—use lowest effective dose with continuous monitoring.

• Labor and delivery. Intravenous adrenaline may reduce uterine blood flow and cause fetal hypoxia; reserve for maternal anaphylaxis or cardiac arrest only.

• Peripheral vascular disease or Raynaud’s phenomenon. Extreme vasoconstriction may precipitate digital ischemia; prefer central administration or dilute infusion with close perfusion checks.

• Sulfite hypersensitivity. Some formulations contain sodium metabisulfite; ADRENALINE AGUETTANT is sulfite-free, yet confirm label if patient has documented sulfite allergy.

• Pheochromocytoma diagnostic use. Avoid adrenaline challenge tests; disproportionate response risks catastrophic hypertension.

Storage of ADRENALINE AGUETTANT 0.1 mg/ml

• Temperature. Store at 15 – 25 °C (59 – 77 °F). Do not freeze; crystals degrade potency and compromise syringe integrity.

• Protection from light. Adrenaline oxidizes to adrenochrome under UV exposure, turning pink-brown and losing activity—keep syringes in the original light-resistant foil pouch until use.

• Shelf-life. Typically 24–36 months unopened. Once the pouch is opened, maintain sterility; any partially used syringe must be discarded immediately.

• Inspection. Do not use if the solution appears discolored, cloudy, or contains particulates. Oxidative discoloration indicates loss of ≥ 20 % activity.

• Crash cart placement. Position in the top drawer with other resuscitation drugs; record batch numbers and perform monthly inventory checks to rotate stock and monitor expiry.

• Disposal. Treat as pharmaceutical biohazard. Expired or unused syringes should be incinerated according to hospital protocols; never flush into sewer systems.