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Adrenalin - použítí a dávky

18. 10. 2013

 

Adrenalin

Základní ředění 1:1000      1 ml = 1 mg tj. 1000 ug

Další časté ředění 1:10 000 1 ml = 0.1 mg  tj. 100 ug


Jak provedu ředění 1:10 000 ?

Provedení ředění 1:10 000. Vezmu ampulku s Adrenalinem v ředění 1:1000 tj. :1 ml = 1 mg. Natáhnu jí do 10 ml stříkačky a dotáhnu do 10 ml fyziologickým roztokem.

Pak  jednotlivé dílky znamenají :


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Akutní subglotická laryngitida:


Děti


Základní ředění k nebulizaci: Adrenalin 5 mg ( tj. 5 ml naředit do 5 ml FR ) , dítě inhaluje z této směsi.

 

Adrenalin při anafylaktickém šoku:


Děti


I.M. - preferováno, S.C. nedoporučeno !

 

Podat intramuskulárně (střední třetina anterolaterální strany stehna) v dávce:


500 ug = 0,5 ml 1:1000 (dospělí a děti nad 12 roků)

300 ug = 0,3 ml 1:1000 (děti 6-12 roků), lze i komerční přípravek EpiPen

150 ug = 0,15 ml 1:1000 (děti do 6 roků), lze i komerční přípravek EpiPen Jr


Odkaz na stránky výrobce: http://www.epipen.com/About-EpiPen


Dávku možno opakovat za 5 -15 minut dle efektu


I.V. - ( nutná opatrnost - dohled ARO, JIP )


Infuze:

Preferována doporučená infuze : Adrenalin 1:1000 tj. 1 mg naředit do 250 ml 5% glukózy iniciální rychlost je 1 ug za minutu tj: cca 12 ml/ hodinu této směsi.

 

Bolusově:


Různé zdroje, různé dávky nejčastější uváděná dávka je: 1 ug / kg dítěte a dále dle odezvy.


Dospělý


I.V. - preferováno


Adrenalin v úvodní dávce 50 ug i.v., opakovat podle potřeby, při nutnosti častého opakování je doporučeno zahájit kontinuální podávání adrenalinu v úvodní dávce 0,1ug/kg/min. ( tj . pro 70 kg pacienta cca 0.42 mg / hodinu )

Ředit 5 mg Adrenalinu do 50ml 5% glukózy pak nastavená rychlost LD 5 ml /hod bude cca 0.5 mg / hod. i.v.


I.M. - nelze-li i.v.


Podat intramuskulárně (střední třetina anterolaterální strany stehna) v dávce:

500 ug = 0,5 ml 1:1000 (dospělí a děti nad 12 roků)


Resucitace


Dítě : 10 ug/kg podávat v ředění 1:10 000 , postup ředění viz výše. ( 5 kg Dítě 5x10 = 50 ug tj. 0.5 ml v ředění 1:10 000 )

Dospělá : 1 mg v ředění 1:1000 tj. 1 ml




 

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