Phenylephrine: Difference between revisions
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===Low Flow [[Priapism]]=== | ===Low Flow [[Priapism]]=== | ||
#[[Phenylephrine]] | |||
#*Dilute phenylephrine 1mg in 9mL NS for final concentration of 100mcg/mL | |||
#**For 500 mcg/ml, take 0.5 ml of 10mg/ml phenylephrine, and dilute in 9.5 cc NS | |||
**For 500 mcg/ml, take 0.5 ml of 10mg/ml phenylephrine, and dilute in 9.5 cc NS | #*Inject base of penis with 29-Ga needle (after blood aspiration to confirm position) | ||
#**100-500 mcg every 3-5min (max 1000 mcg) until resolution or 1 hour | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
Revision as of 21:34, 6 July 2017
General
- Type: Vasopressors
- Dosage Forms:
- Common Trade Names:
Adult Dosing
General
- Start 100-200 mcg/min then taper down
- 40-60 mcg/min works for most
Low Flow Priapism
- Phenylephrine
- Dilute phenylephrine 1mg in 9mL NS for final concentration of 100mcg/mL
- For 500 mcg/ml, take 0.5 ml of 10mg/ml phenylephrine, and dilute in 9.5 cc NS
- Inject base of penis with 29-Ga needle (after blood aspiration to confirm position)
- 100-500 mcg every 3-5min (max 1000 mcg) until resolution or 1 hour
- Dilute phenylephrine 1mg in 9mL NS for final concentration of 100mcg/mL
Pediatric Dosing
Special Populations
- Pregnancy Rating: C
- Lactation: infant risk cannot be ruled out
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
- Baroreceptor-mediated reflex bradycardia
- If extravasates use phentolamine
Serious
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
Primary Receptor
- α1
Relative Effects
- ↑SVR
- ↓HR (reflex bradycardia)
Notes
- Use with caution in patients with spinal cord injury-related bradycardia
- Useful for treatment of vasodilatory shock when norepinephrine or dopamine have precipitated tachyarrhythmias
- In patients with ↓LV function, unopposed α1 may lead to decreased CO or myocardial ischemia
- However clinical trials do not support these effects when used in clinically appropriate dose range
Indication
- Neurogenic Shock