Adrenaline

I know many here carry ""pens"" and I have been given adrenaline a couple of times during splatts I swear it does nothing for me. A while ago I was asked by a gasman if I had adrenaline nebs ever, I have never had them and as adrenaline does nothing for me it was deemed pointless. I just wondered what do adrenaline nebs do. Are they worth considering or as my attacks are rarely induced by an allergic reaction are they worthless.

Bex

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  • Hi Becks

    Hope your ok, I had an adrenaline neb once during a bad attack and all it did was make me feel really light headed, I swear I was high as a kite! but it didn't really help my asthma! I've been wondering for ages why they gave it to me cause I don't have any allergies!

  • Adrenaline nebs aren't so much for any allergic component of the asthma, more for what they actually do - I have experience of using them on patients with laryngeal oedema, not asthma, but I'm guessing the principle is the same.

    (As an aside, you may be aware that some people have epipens for asthma alone, rather than for allergies per se).

    Adrenaline is a potent vasoconstrictor - it makes blood vessels shrink down - and as such it is good for reducing oedema (swelling). If you think back to your basics of asthma physiology, one of the features is oedema of the airways, or swelling, brought about by inflammation (the features are more easily remembered by thinking of the 3 ""S""s - Swelling (oedema), Spasm (bronchoconstriction), and Sputum (mmm, that lovely mucus)). Anyhoo, the adrenaline nebs work to reduce the oedema of the airways, which is present whether your asthma is allergic type - or not.

    Hope this helps....if I have garbled and not made sense, please point this out so I can rectify (brain squiffy as just been on training run, urrrghhh).

    CathBear

  • Oh, incidentally I should mention - adrenaline doesn't treat the root cause of an allergic reaction/anaphylaxis, rather, it treats the symptoms (low blood pressure, swelling, vasodilation etc etc). What it does do is hold the symptoms in check until antihistamines do their job - tackling the allergic reaction and ""taking it down""!!

  • Some of the older inhalers in the past used to be adrenaline type drugs and

    there were more side effects that ventolin etc. (Cant remember the names of the drug)

    As Cath says, it sorts out the symptoms of anaphylaxis but doesn't stop the allergic reaction which needs clobbering with anti histamines & steroids to dampen down the reaction.

    This is why adrenaline works for severe asthma too - epipens work a treat for me though the effects do wear off after 20 mins or so but that gives time to get to A&E or have another epipen.

    A very few asthmatics can't take ventolin or bricanyl and use inhaled adrenaline.

    I carry my epipens for both asthma & anaphylaxis but have used them most for asthma & only once for anaphylaxis.

    Kate

  • Suddenly developing asthma in the USA & the nearest doctor being 4 hours away, i used over-the-counter. crammed-with-CFC Primatine Mist Epinepherine Inhaler for Broncial Asthma. I was on max dose for a month & it was incredibly effective (ever get the feeling you suddenly have a massive airway?!) but the side effects were pretty bad: insomnia, shaking, insane heart rate, hyperactivity, exhaustion etc, not to mention the huge risk of sudden bronchospasm due to the adrenaline and of cardiac failure (one girl died on the same inhaler).

    My GP was freaked that i'd been living on huge amounts of adrenaline for ages (not so great as ive had alot of heart problems) when i finally got around to seeing him. I couldn't see his point untill he got out the gadgets revealing my RESTING heart rate was 150-200 :@

    Anyhu, seriously though it's better to stick with the salbutamol inhalers/nebs unless they really dont work/need something extra - they're WAAAY safer!

    WheezySurf x

  • My nephew had adrenaline nebs when he was a baby and had such severe croup his airway swelled it worked a treat and prevented him being vented, must have been oedema like cath said.

    Andrea xx

  • I've had adrenaline nebs alot when I have a severe attack BUT they need to be given in a controlled medical environment, there are so many risk ascociated with them.

    They are used in me because when IV amino and bricanyk dont work and Ive had a bucket full of Anapens (adrenaline injections) they [refer to use something that will act directly on the air ways.

    Yes I have a bucket full of anaphylactic allergies but when my asthma kicks of my throat and airways constrict to the point they want to ventilate me.

    Adrenaline nebs reduce the swelling and avert venting in me in alot of my past admissions (have been vented alot before they started to use adrenaline (anapens) injections to treat me when I hace a sudden unpredictable attack.

    Every time Ive need adrenaline nebs I was moved to ITU first as the wards and NIVU were just no set up for monitoring a patient needing adrenaline nebs.

    Adrenaline is no miracle treatment, its a very old and far surpassed treatment and is reserved for those situations where no newer treatments have worked or are suitable.

  • Oh Lordy yes I didn't make the point, did I, that they're generally hossie use only cos of the side effects and the monitoring needed. Not like salbutamol/atrovent nebs that you can quite safely have at home as part of a comprehensive management plan. Adrenaline ain't the wisest plan if you have certain known heart problems, either, though of course in many situations it's a case of what's more risky - the treatment or not treating, if you catch my drift.

  • Cheers folks. As I said I have never thought the adrenaline injections worked for me but who knows they may have brought valuable time whilst I am transported to hospital. I have never refused them mind you I a normally past refusing anything :(

    Bex

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