Adrinor Injection

Adrinor is a direct-acting sympathomimetic agent exerting its effect on alpha and beta-adrenoceptors. The overall effect of adrenaline depends on the dose, and may be complicated by the homeostatic reflex responses. In resuscitation procedures it is used to increase the efficacy of basic life support. It is a positive cardiac inotrope. Major effects are increased systolic blood pressure by arterioral and venous vasoconstriction (alpha1 effects), reduced diastolic pressure, tachycardia and hyperglycaemia. Adrinor is rapid in onset and with short duration. After IV infusion the half-life is approximately 5-10 minutes. It is rapidly distributed to the heart, spleen, several glandular tissues and adrenergic nerves. Adrinor is rapidly metabolised in the liver and tissues by oxidative de-amination and O-methylation followed by reduction or by conjugation with glucuronic acid or sulphate. Up to 90% of the IV dose is excreted in the urine as metabolites. It is approximately 50% bound to plasma proteins.

Uses

Adjunctive use in the management of cardiac arrest. It is used in cardiopulmonary resuscitation. Intracardiac puncture and intramyocardial injection of adrenaline may be effective when external cardiac compression and attempts to restore the circulation by electrical defibrillation or use of a pacemaker fail. Adrinor is a drug that leads to increased blood pressure, increased heart rate, increased air entry, increased blood glucose, stimulates cardiac activity and reduces allergic reactions by reducing inflammatory response caused by histamine. Due to these properties, it is used for the treatment of allergic and anaphylactic reactions. Adrinor is the favored treatment for anaphylactic shock and should be administered immediately if a person begins exhibiting severe allergic reactions. Adrinor is also used in life threatening asthma when failing ventilation and continued deterioration despite nebulizer therapy.

Trade Name Adrinor
Generic Adrenaline
Weight 1 mg/ml
Type Injection
Therapeutic Class Anaphylaxis, Mydriatic and Cycloplegic agents, Other adrenoceptor stimulants, Respiratory stimulants: analeptics.
Manufacturer Incepta Pharmaceuticals Ltd, Incepta Pharmaceuticals Limited
Available Country India, Bangladesh
Last Updated: June 23, 2021 at 9:00 am

Dosage

Adrinor dosage

Cardiac arrest:

1. Intravenous injection: 1 mg injection repeated every 2-3 minutes as necessary.

2. Endotracheal: 2-3 mg via an endotracheal tube, repeated as necessary.

3. Intracardiac injection: 0.1 to 1 mg, direct into the atrium of the heart.

4. Intraspinal use: Usual dose is 0.2 to 0.4 mg added to anesthetic spinal fluid mixture (to prolong anesthetic action by limiting absorption).

Anaphylaxis, asthma or severe bronchospasm: Adult dose is 0.25 - 0.5 mg. It may be repeated at 5 minutes intervals until perfusion and respiratory status normalizes. In case of dose dilution: 1 mg of Adrinor to be diluted in 9 ml Normal Saline.

Children: Intravenous injection: Initially 10 mcg/kg body weight, not to exceed 250 mcg. May be repeated every 3-5 minutes if necessary. Subsequent doses should be 100 mcg/kg.

Side Effects

Anxiety, restlessness, dizziness, headache, palpitations, rapid pulse, tremors, weakness and coldness of the extremities may be reported even with small doses and especially when given in conjunction with local anaesthetics.

Precaution

The solution should not be used if it is pinkish or darker than slightly yellow or if it contains a precipitate. Adrinor is readily destroyed by alkalies and oxidizing agents. In the latter category are Oxygen, Chlorine, Iodine, Permanganates, Chromates, Nitrites and salts of easily reducible metals, especially Iron. Adrinor should not be mixed with Sodium bicarbonate; the solution is oxidised to adrenochrome and then forms polymers.

Special warnings and precautions for use

Administer slowly with caution to elderly patients and to patients with ischemic heart disease, hypertension, diabetes mellitus, hyperthyroidism or psychoneurosis. Use with extreme caution in patients with long-standing bronchial asthma and emphysema who have developed degenerative heart disease. Anginal pain may be induced when coronary insufficiency is present.

Interaction

Use of Adrinor with excessive doses of digitalis, mercurial diuretics or other drugs that sensitize the heart to arrhythmias is not recommended. The adverse effects of Adrinor may be potentiated by tricyclic antidepressants; certain antihistamines; e.g, Diphenhydramine, Tripelennamine, Chlorpheniramine and L-thyroxine Sodium.

Pregnancy & Breastfeeding use

Pregnancy Category C. It crosses the placenta and is excreted in breast milk. Adrinor should only be used in pregnancy if the potential benefits outweigh the risks to the fetus.

Lactating mothers: It is excreted in breast milk and therefore Adrinor is not recommended for use during lactation because of the risk of adverse effects of infants.

Contraindication

Hypertension, arteriosclerosis, coronary disease and hyperthyroidism. Not to be given to patients taking monoamine oxidase inhibitors.

Acute Overdose

Symptoms: Cardiac arrhythmia leading to ventricular fibrillation, severe hypertension leading to pulmonary edema and cerebral hemorrhage.

Treatment: Combined alpha and beta-adrenergic blocking agents such as Labetalol may counteract the effects of adrenaline, or a beta-blocking agent may be used to treat any supraventricular arrhythmias and Phentolamine to control the alpha-mediated effects on the peripheral circulation. Rapidly acting vasodilators such as nitrates and Sodium Nitroprusside may also be helpful. Immediate resuscitation support must be available.

Interaction with other Medicine

Use of Adrinor with excessive doses of digitalis, mercurial diuretics or other drugs that sensitize the heart to arrhythmias is not recommended. The adverse effects of Adrinor may be potentiated by tricyclic antidepressants; certain antihistamines; e.g, Diphenhydramine, Tripelennamine, Chlorpheniramine and L-thyroxine Sodium.

Storage Condition

Store below 25 °C. Protect from light.

Adrinor contains Adrenaline see full prescribing information from innovator Monograph

FAQ

What is Adrinor?

Adrinor (Acetylcysteine) also known as N-acetylcysteine (NAC), is a medication that is used to treat paracetamol (acetaminophen) overdose, and to loosen thick mucus in individuals with chronic bronchopulmonary disorders like pneumonia and bronchitis. It can be taken intravenously, by mouth, or inhaled as a mist.

What is Adrinor used for?

Adrinor inhalation is used along with other treatments to relieve chest congestion due to thick or abnormal mucous secretions in people with lung conditions including asthma, emphysema, bronchitis and cystic fibrosis (an inborn disease that causes problems with breathing, digestion, and reproduction).

What are the side effects of Adrinor?

Adrinor is Likely safe for most adults. It can cause nausea, vomiting, and diarrhea or constipation. Rarely, it can cause rashes, fever, headache, drowsiness, low blood pressure, and liver problems.

Who should not take Adrinor?

If you have asthma or bleeding problems, your doctor may tell you to avoid Adrinor. You will likely be told to stop Adrinor 2 weeks before any elective surgery. If you're pregnant or breastfeeding, you must check with a doctor before using Adrinor supplements.

How long does Adrinor take to work?

The study showed that Adrinor significantly reduced the symptoms of trichotillomania compared to a placebo. 56% of subjects reported "much or very much improved" on Adrinor compared to 16% on placebo (sugar pill or inert substance). Significant improvement was initially noted after 9 weeks of treatment.

When is the best time to take Adrinor?

Single amino acid supplements, like Adrinor, are best taken on an empty stomach. The absorption of amino acids can be affected by the foods you take them with and by other amino acids.

Is Adrinor safe to take daily?

There is no recommended daily allowance for Adrinor, because unlike vitamins, it's not an essential nutrient. The dosage used to prevent radio contrast dye damage is 600 mg to 1200 mg every 12 hours for 48 hours.

What are the benefits of taking Adrinor?

Classic mucolytic drugs such as Adrinor decrease the viscoelastic properties of mucus by reducing disulfide bonds. In contrast, expectorants change mucus consistency and make coughing more productive, mucokinetics improve transportability, and mucoregulators suppress mucus secretion.

Does Adrinor really work?

Adrinor supplements have been used to improve COPD symptoms, exacerbations and lung decline. In a one-year study, 600 mg of Adrinor twice a day significantly improved lung function and symptoms in those with stable COPD. Those with chronic bronchitis can also benefit from Adrinor.

Is Adrinor safe in pregnancy?

Animal studies did not show teratogenicity; slightly decreased fertility was seen at doses above the maximum human dose. Limited case reports did not report any adverse fetal or neonatal outcomes. This drug crosses the placenta and was measurable in the serum of the infant. Pregnant women should be managed the same way as nonpregnant patients for acetaminophen overdose, and that acetylcysteine therapy was protective to both mother and fetus. There are no controlled data in human pregnancy. Use is not recommended unless clearly needed.

Is Adrinor safe during Breastfeeding?

Animal studies did not show adverse effects during lactation. It is unknown in this drug or its metabolites are excreted in milk. Based on the pharmacokinetics, it should be nearly cleared 30 hours after administration. Use is not recommended.