Adrenalin - použítí a dávky
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 :
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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