Phenylephrine (When ATH R01AA04)

When ATH:
R01AA04

Characteristic.

White or white with a slightly yellowish white, crystalline powder;. The easily soluble in water and alcohol.

Pharmacological action.
Vasoconstrictive.

Application.

Subdural and inhalation anesthesia (to maintain adequate blood pressure and extension subdural anesthesia), local anesthesia (as vasoconstrictor), acute circulatory failure, anaphylaxis, neurogenic shock, gipotenziya, incl. orthostatic, paroxysmal supraventricular tachycardia, reperfusion arrhythmias (reflex Bercol′da-Jarisch), priapism, secretory prerenal anuria, Irit, iridocyclitis.

Contraindications.

Hypersensitivity, severe hypertension, ventricular tachycardia, propensity to vasoconstriction, bradycardia, shock in myocardial infarction, decompensated heart failure, conduction disorders, expressed atherosclerosis, severe coronary artery disease, loss of cerebral arteries, arterial hypertension, acute pancreatitis and hepatitis, hyperthyroidism, thrombosis, peripheral and mesenteric arteries, prostatauxe, pregnancy, children's (to 15 years) and old age.

Side effects.

Headache, excitation, anxiety, irritability, weakness, dizziness, hypertension, bradycardia, arrhythmia, precordialgia, respiratory depression, oligurija, Acidosis, pale skin, tremor, paresthesia, local ischemia in the skin at the injection site, necrosis and the formation of a scab when released into the tissue or s / c injection.

Cooperation.

Oxytocin, MAO inhibitors, tricyclic antidepressants, ergot alkaloids, enhance the pressor effect sympathomimetic, and the last and — aritmogennosti. Alpha-blockers (phentolamine), fenotiazinы, furosemide and other diuretics inhibit vasoconstriction. Beta-blockers negate cardio activity, against the backdrop of reserpine possible hypertension (due to the depletion of catecholamines in the adrenergic neurons increased sensitivity to sympathomimetics).

Overdose.

Manifested ventricular premature beats and short paroxysms of ventricular tachycardia, feeling of heaviness in the head and legs, a significant increase in blood pressure.

Treatment: / in the introduction of the alpha-blockers (eg, phentolamine) and beta-blockers (rhythm disturbances).

Dosing and Administration.

P /, / m, I / bolus or slow infusion (at a speed of 60-120 ml/h). For in / bolus 10 mg dissolved in 9 ml of water, for in/infusion in 10 mg added to 500 ml 0,9% sodium chloride or 5% Glucose. Moderate gipotenzia — n/a 2-5 mg (1-10 Mg); I / 0,2 mg (0,10.5 mg), the interval between wvedeniami — not less than 10-15 min. Heavy gipotenzia and shock-in/in the drip; initial speed infusion 0.1-0.18 mg/min, HELL stabilized speed reduced to 0.04-0.06 mg/min. Paroxizmalnaya najeludochkovaya tachycardia-in/in struino, the initial dose of no more than 0,5 mg for 20-30 with, dose gradually increased at 0.1-0.2 mg, 1 mg not more. Before subdural anesthesia (for the prevention of arterial hypotension) Enter 2-3 mg/m or 0,2 mg (the maximum is up to 0,5 mg) in / in for 3-4 minutes before the procedure. For prolongation of subdural anesthesia is 2-5 mg added to anaesthetic. As a vasoconstrictor in regional analgesia is added to the anesthetic solution based 1 mg 20 ml.

Precautions.

For induction of labor is not recommended for use in combination with drugs oksitotsinsoderzhaschimi (possible severe persistent hypertension and cerebral vascular damage with the development of hemorrhagic stroke in the postpartum period). During treatment should monitor the ECG, FROM, wedge pressure in the pulmonary artery, cardiac output, blood circulation in the extremities and at the injection site. When hypertension is necessary to maintain the garden level, on 30-40 mm Hg. lower than usual. Before the start of or during treatment required correction of hypovolemia, hypoxia, acidosis, giperkapnii. The sharp increase in blood pressure, bradycardia or tachycardia, persistent arrhythmias require discontinuation of treatment. To prevent re-BP reduction after the drug dose should be reduced gradually, especially after prolonged infusion. Infusion resume, If the garden is reduced to 70-80 mm Hg. During therapy eliminated potentially dangerous activities, requiring speed motor and mental reactions.

Cooperation