metaraminol
Table of Contents
metaraminol (Aramine)
see also:
introduction
- a vasopressor which can be used as iv bolus peripherally for short term Mx of hypotension
- it is particularly useful at induction of anaesthesia to counteract the hypotensive effects of most induction agents in at risk patients where iv fluid bolus is not sufficient.
- mechanism of action:
- indirect action via stimulating release of noradrenaline / norepinephrine
- direct actions as alpha agonist and to a lesser extent, beta agonist
- duration of action ~20 min following iv bolus
- avoid in cardiogenic shock or decompensated mitral regurgitation where increased LV afterload may be harmful.
- marketed as Aramine
adverse reactions
- allergy and hypersensitivity reactions in patients sensitive to sulphites - thus care in patients with asthma
- ventricular arrhythmias including ventricular tachycardia (VT), especially in patients with acute myocardial infarction (AMI/STEMI/NSTEMI)
- severe hypertension if excessive dosing which may cause acute pulmonary oedema (APO), ventricular tachycardia (VT) and choking / respiratory arrest / cardiac arrest / BLS / ALS / CPR
- cumulative effect is possible which may cause prolonged hypertension
- vasoconstriction
- use with care in those with heart disease, thyroid disease, hypertension, or diabetes
- may cause local ischaemia and abscesses if used im
- prolonged vasoconstriction may prevent adequate volume expansion of circulation and lead to persistent shock
- may cause fetal hypoxia in pregnant patients
iv bolus doses for acute Mx of hypotension not due to volume loss
- usual bolus dose 0.5-1mg repeated as necessary with care
- DO NOT give 1 ampoule as bolus - 1 ampoule contains 10mg!!
- dilute 1 ampoule to 10ml to allow more precise titrated doses.
metaraminol.txt · Last modified: 2012/04/13 04:30 by 127.0.0.1