ADRENALINE INJECTION BP 1:1000 (1mg/ml) Injection/Solution for

What is ADRENALINE INJECTION BP 1:1000 (1mg/ml)

ADRENALINE INJECTION BP 1:1000 (1mg/ml) is a potent emergency medication used for the rapid management of severe allergic reactions and other critical conditions. The active ingredient, Adrenaline (also known as epinephrine), is a naturally occurring hormone and neurotransmitter that plays a central role in the body's "fight or flight" response.

• Pharmaceutical Form: Sterile solution for injection, typically administered intramuscularly or subcutaneously.
• Concentration: 1:1000, meaning 1mg of adrenaline in 1ml of solution.
• Indications:
  • Anaphylaxis (life-threatening allergic reactions)
  • Severe asthma attacks unresponsive to conventional treatment
  • Cardiac arrest (as part of advanced life support)
  • Acute hypotension in sepsis or anesthesia-related complications
• Mechanism: Acts as a non-selective adrenergic agonist affecting alpha and beta receptors to quickly reverse symptoms of hypotension, bronchoconstriction, and tissue swelling.

Its fast onset and wide spectrum of action make it an essential medication in emergency kits, ambulances, and healthcare facilities.

How to use ADRENALINE INJECTION BP 1:1000 (1mg/ml)

Adrenaline injection should only be administered under the supervision of trained healthcare professionals or in emergencies by individuals instructed in its proper use. The route and dose depend on the indication and the patient's condition.

• Emergency Anaphylaxis:
  • Route: Intramuscular injection (IM), preferably in the mid-outer thigh.
  • Dose: Adults – 0.3 to 0.5 mg (0.3–0.5 ml) IM. May repeat every 5–15 minutes as needed.
  • Children – 0.01 mg/kg IM, max dose 0.3 mg.
• Asthma (Severe Acute):
  • Route: Subcutaneous or intramuscular.
  • Dose: 0.01 mg/kg (max 0.5 mg for adults, 0.3 mg for children).
• Cardiac Arrest (Note: Use 1:10,000):
  • This formulation (1:1000) must be diluted for intravenous use.

Important Notes:

• Check the solution clarity and expiration before use.
• Never inject into buttock or fingers (risk of tissue necrosis).
• Seek immediate medical attention after self-administration.

Mode of Action ADRENALINE INJECTION BP 1:1000 (1mg/ml)

Adrenaline (epinephrine) is a potent non-selective adrenergic agonist, meaning it stimulates both alpha and beta adrenergic receptors throughout the body. This mechanism of action makes it extremely effective in life-threatening conditions.

• Alpha-1 receptor stimulation:
  • Causes vasoconstriction (narrowing of blood vessels)
  • Increases blood pressure and reduces mucosal edema in airways
• Beta-1 receptor stimulation:
  • Increases heart rate (positive chronotropic effect)
  • Increases cardiac output and contractility (positive inotropic effect)
• Beta-2 receptor stimulation:
  • Relaxes bronchial smooth muscles (bronchodilation)
  • Inhibits the release of inflammatory mediators from mast cells and basophils

This broad receptor activity leads to rapid reversal of hypotension, bronchospasm, and airway edema — the three critical features of anaphylaxis and severe asthma.

ADRENALINE INJECTION BP 1:1000 (1mg/ml) Interactions ADRENALINE INJECTION BP 1:1000 (1mg/ml)

Adrenaline can interact with several drugs, influencing its efficacy and safety profile. These interactions can be pharmacodynamic or pharmacokinetic in nature and must be carefully monitored, especially in emergency and intensive care settings.

• Beta-blockers (e.g., Propranolol):
  • May antagonize the bronchodilatory effects of adrenaline
  • Risk of severe hypertension and bradycardia due to unopposed alpha activity
• Tricyclic Antidepressants (e.g., Amitriptyline):
  • Potentiate the cardiovascular effects of adrenaline
  • Increased risk of arrhythmias and hypertension
• Monoamine Oxidase Inhibitors (MAOIs):
  • Can enhance and prolong the effects of adrenaline
  • May lead to hypertensive crises
• General Anesthetics (e.g., Halothane):
  • Increase sensitivity of the heart to adrenaline
  • Elevated risk of arrhythmias, including ventricular fibrillation
• Diuretics and Digoxin:
  • Combined use can elevate the risk of cardiac arrhythmias

Always review patient medication history before administering adrenaline, especially in patients with cardiovascular disease or on psychiatric medications.

Dosage of ADRENALINE INJECTION BP 1:1000 (1mg/ml)

Adrenaline dosage must be tailored to the patient's age, weight, clinical condition, and route of administration. Only trained personnel should administer IV doses after appropriate dilution.

• Anaphylaxis:
  • Adults: 0.3–0.5 mg IM every 5–15 minutes if needed
  • Children: 0.01 mg/kg IM (max 0.3 mg) every 5–15 minutes if required
• Severe Asthma:
  • Adults: 0.3–0.5 mg SC or IM every 20 minutes for up to 3 doses
  • Children: 0.01 mg/kg per dose (maximum 0.3 mg)
• Cardiac Arrest (after dilution):
  • Use 1:10,000 formulation (0.1 mg/ml)
  • Typical IV dose: 1 mg every 3–5 minutes during resuscitation

Important:

• Use IM route for rapid absorption during emergencies
• IV administration should be performed with ECG monitoring
• Do not exceed recommended doses to avoid cardiovascular complications

Possible side effects of ADRENALINE INJECTION BP 1:1000 (1mg/ml)

While adrenaline is life-saving, its use is associated with various side effects, especially when used in high doses or in sensitive individuals. Most side effects result from overstimulation of adrenergic receptors.

• Cardiovascular Effects:
  • Palpitations
  • Hypertension
  • Tachycardia
  • Arrhythmias
• CNS Effects:
  • Headache
  • Anxiety
  • Nervousness
  • Dizziness
  • Tremors
• Local Effects (at injection site):
  • Pain
  • Tissue necrosis (if injected into digits or improperly administered)
• Other Possible Reactions:
  • Nausea and vomiting
  • Cold extremities
  • Restlessness

These effects are usually short-lived due to adrenaline's rapid metabolism. Nonetheless, monitoring is necessary in patients with underlying heart disease or those requiring repeated dosing.

ADRENALINE INJECTION BP 1:1000 (1mg/ml) Contraindications ADRENALINE INJECTION BP 1:1000 (1mg/ml)

Adrenaline has few absolute contraindications in emergency settings, as its use may be life-saving. However, in non-emergency situations or where alternatives are available, it may be contraindicated in certain individuals.

• Absolute Contraindications:
  • None in the setting of anaphylaxis or cardiac arrest
• Relative Contraindications (use with caution):
  • Severe hypertension
  • Coronary artery disease or history of myocardial infarction
  • Hyperthyroidism
  • Pheochromocytoma
  • Narrow-angle glaucoma
  • Pregnancy (risk-benefit must be assessed)
• Drug-Specific Warnings:
  • Use cautiously with MAO inhibitors or tricyclic antidepressants
  • Monitor closely in patients taking beta-blockers

Despite potential risks, adrenaline remains the treatment of choice for anaphylaxis due to its ability to reverse life-threatening symptoms rapidly.

Storage of ADRENALINE INJECTION BP 1:1000 (1mg/ml)

Proper storage of adrenaline is essential to maintain its efficacy and safety. Degradation or exposure to improper conditions can lead to loss of potency and compromised emergency response.

• Storage Temperature:
  • Store at 25°C or below (77°F)
  • Short-term exposure up to 30°C may be acceptable
• Light Sensitivity:
  • Protect from light; store in the original package
  • Discard if solution becomes discolored (should be clear and colorless)
• Shelf Life:
  • Check expiration date on the ampoule or box
  • Discard any unused ampoule if opened
• Disposal:
  • Follow local guidelines for disposal of medical waste

Healthcare providers should regularly check emergency kits to ensure that adrenaline ampoules are intact, unexpired, and stored correctly for reliable emergency use.