Vasopressors phenylephrine

Phenylephrine is a fast-acting, short-duration a, agonist. Phenylephrine has primarily vascular effects, and does not impair cardiac or renal function. Phenylephrine is useful when tachycardia limits the use of other vasopressors.24,27-28... 

Discontinue antihypertensive medications IV fluids to maintain systolic blood pressure greater than 80-90 mm Hg or vasopressor support with an a-agonist such as phenylephrine as indicated. 

Phenylephrine, Nasal (Neo-Synephrine Nasal) (OTC) [Vasopressor/Decongestant] Uses Can be used prior to nasal intubation and NG tube insCTtion to reduce bleeding Action a-Adren gic agonist Dose Adults Feds. 1—2 sprays/nostril q4h (usual 0.25%).Caution [C, +/—] HTN, acute pancreatitis, H, coronary Dz, NAG, h5 pCTth5Toidism Contra Bradycardia, arrhythmias Disp Nasal soln (0.125-0.25%) SE Arrh5rthmias, HTN, nasal irritation, dryness, sneezing, HA Interactions May -1- effects OF nitrates EMS Ocular instillation may dilate pupil... 

Phenylephrine Ophthalmic (Neo-Synephrine Ophthalmic, AK-Dilote, Zincfrin [OTC]) [Vasopressor/Decongestant]... 

Phenylephrine, Oral (Sudafed PE, SudoGest PE, Nasop, Lusonal, AH-chew D, Sudafed PE Quick Dissolve) (OTC) [Vasopressor/Decongestant] WARNING Prescribers should be aware... 

The vasopressor response seen with phenylephrine is particularly strong because it is an a -selective agonist. 02-Agonists actually lower the blood pressure, which is in accord with the role of the 02-receptors in presynaptic inhibition. This inhibition is shown in Figure 10.7a The re-... 

Thyroid Disease. Elevated blood pressure or other adverse cardiovascular effects can result when patients with Graves disease receive adrenergic agonists with vasopressor activity. This is due to the increased catecholamine activity associated with hyperthyroidism. The primary agent to be avoided or used cautiously is topically applied phenylephrine for pupillary dilation. 

Systemic Effects. Ocular administration of phenylephrine has been reported to induce acute hypertension (see Table 8-2). Sixty patients were studied after three applications of the 10% solution in each eye at 10-minute intervals.Thirty minutes after the last drop, systolic elevations of 10 to 40 mm Hg and diastolic elevations of 10 to 30 mm Hg occurred in all subjects. In each case pulse rate decreased 10 to 20 beats per minute. In contrast to these observations, however, other investigators reported a lack of systemic vasopressor response with the 10% concentration. 

Hypotension not responsive to intravenous fluids should be managed with vasopressors, such as dopamine, norepinephrine, epinephrine, and/or phenylephrine. If seizures occur, benzodiazepines should be administered. Due to their pharmacokinetic characteristics, moderate volume of distribution, and low protein binding, procainamide and NAPA may be removed via hemodialysis and hemoperfu-sion. Both procainamide and NAPA serum concentrations should be obtained. Normal therapeutic ranges are procainamide, 3-14pgml NAPA, 12-35 pg ml Measurement of electrolytes, renal function tests, and arterial blood gases should be considered. 

Clinically important, potentially hazardous interactions with albuterol, alpha-blockers, amitriptyline, amoxapine, atenolol, beta-blockers, carteolol, chlorpromazine, clomipramine, cocaine, desipramine, doxepin, ephedra, ergotamine, furazolidone, halothane, imipramine, insulin detemir, MAO inhibitors, metoprolol, nadolol, nortriptyline, oxprenolol, penbutolol, phenelzine, phenoxybenzamine, phenylephrine, pindolol, prazosin, propranolol, protriptyline, sympathomimetics, terbutaline, thioridazine, timolol, tranylcypromine, tricyclic antidepressants, trimipramine, vasopressors... 

Catecholamine vasopressors may result in adverse peripheral vasoconstrictive, metabolic, and dysrhythmogenic effects that limit or outweigh their positive effects on the central circulation. Norepinephrine, phenylephrine, and epinephrine can produce a lactic acidosis secondary to excessive constriction in peripheral arterioles. 

Agents commonly considered for vasopressor or inotropic support include dopamine, dobutamine, norepinephrine, phenylephrine, and epinephrine (Table 117 ). Dopamine, an a- and -adrenergic agent with dopaminergic activity, appears to increase MAP effectively in patients who remain hypotensive with reduced cardiac function after aggressive fluid resuscitation. Thus it is often the initial choice in sepsis because of combined vasopressor and inotropic effects. While low-dose dopamine (1 to 5 mcg/kg per minute) is effective in maintaining renal perfnsion, higher doses (>5 mcg/kg per minute) exhibit a and f) activity and are used frequently to support blood pressure and to improve cardiac function such as an increase in cardiac index (Cl). 

Phenylephrine tannate is an antihistamine/deconges-tant/vasopressor used in shock. 

Phenylephrine tannate is an antihistamine/deconges-tant/vasopressor used in shock. Phenylephrine stimulates postsynaptic alpha receptors, resulting in vasoconstriction, which reduces nasal congestion. Chlorpheniramine and pyrilamine competitively antagonizes histamine at H,-receptor sites. They are indicated in symptomatic relief of coryza and nasal congestion associated with common cold, sinusitis, allergic rhinitis, and other upper respiratory tract conditions. 

Aspirin poisoning leads to inappropriate vasodilation compounded by volume depletion and acidosis, which worsens vasodilation. Aggressive volume repletion with intravenous fluids should be instituted. The aim is to achieve large-volume diuresis to optimize salicylate elimination. If necessary, vasopressors (e.g., norepinephrine, phenylephrine) are added. 

If bronchospasm is predominant, then administration by inhalation of a p -selective agonist like albuterol—or intravenous administration of theophylline—may be useful. If cardiovascular collapse is predominant, then vasopressor drugs may be helpful these include a-adrenoceptor agonists such as phenylephrine and P,-adrenoceptor agonists sueh as dobutamine or dopamine. 

Self-expanding and balloon-expandable stents Resheathable (closed-cell) stents. Solitaire, Trevo, Re Vase Pharmacological vasopressors (e.g., phenylephrine) Mechanical NeuroFlo... 

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