Phenylephrine: Difference between revisions
No edit summary |
No edit summary |
||
| Line 2: | Line 2: | ||
*Type: [[Vasopressors]] | *Type: [[Vasopressors]] | ||
*Dosage Forms: | *Dosage Forms: | ||
*Common Trade Names: | *Common Trade Names: Neosynephrine | ||
==Adult Dosing== | ==Adult Dosing== | ||
| Line 42: | Line 42: | ||
*Metabolism: | *Metabolism: | ||
*Excretion: | *Excretion: | ||
*Mechanism of Action: | *Mechanism of Action: selective α1 agonist causes vasoconstriction | ||
===Primary Receptor=== | ===Primary Receptor=== | ||
*α1 | *α1 | ||
| Line 56: | Line 56: | ||
===Indication=== | ===Indication=== | ||
*Neurogenic Shock | *Neurogenic Shock | ||
*Second line agent for septic shock | |||
==See Also== | ==See Also== | ||
http://www.atsjournals.org/doi/abs/10.1164/rccm.201006-0972CI?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed#readcube-epdf | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Revision as of 23:47, 13 July 2017
General
- Type: Vasopressors
- Dosage Forms:
- Common Trade Names: Neosynephrine
Adult Dosing
Hypotension
- Start 100-200 mcg/min then taper down
- 40-60 mcg/min works for most
Low Flow Priapism
- 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
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: selective α1 agonist causes vasoconstriction
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
- Second line agent for septic shock