Category:

• Nervous system

Description:

• Vasopressor

Indications:

• Acute hypotensive states associated with spinal anesthesia, hemorrhage, reactions to medications, surgical complications

• Shock associated with brain damage resulting from trauma or tumor

• “Probably effective” in hypotension due to cardiogenic shock or septicemia

Contraindications:

• Use with cyclopropane or halothane anesthesia

Precautions:

• Pregnancy category D

• Prolonged administration, heart disease, thyroid disease, hypertension, diabetes

• Cirrhosis, extravasation (phentolamine is antidote), history of malaria

• Sulfite sensitivity

Adverse Reactions (Side Effects):

• CNS: apprehension, dizziness, headache, tremors

• CV: cardiac arrest, flushing, hypertension, hypotension (following cessation), palpitation, sinus tachycardia, ventricular tachycardia, other dysrhymias

• GI: nausea

• SKIN: extravasation (abscess, necrosis, sloughing), sweating

Dosage:

Administered subcutaneously, intramuscularly, intravenously

• Adult:   

  • SC/IM 2-10mg

  • IV INF dilute 15-500mg in 500mg D5W or NS, administer at a rate adjusted to maintain desired blood pressure

  • IV 0.5-5mg as a single dose in severe shock, follow with IV INF

• Child: 

  • SC/IM 0.1 mg/kg or 3 mg/meter square

  • IV INF 0.4 mg/kg or 12 mg/meter square, diluted and administered at a rate adjusted to maintain desired blood pressure

  • IV 0.01 mg/kg or 0.3 mg/meter square as a single dose in severe shock, follow with IV INF