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Pronunciation |
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(met
a RAM i
nole) |
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U.S. Brand
Names |
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Aramine® |
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Generic
Available |
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Yes |
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Synonyms |
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Metaraminol Bitartrate |
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Pharmacological Index |
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Alpha1 Agonist |
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Use |
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Acute hypotensive crisis in the treatment of shock |
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Pregnancy Risk
Factor |
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D |
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Contraindications |
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Hypersensitivity to metaraminol or any component, cyclopropane or halothane
anesthesia, or MAO inhibitors |
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Warnings/Precautions |
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Can cause cardiac arrhythmias; use with caution in patients with a previous
myocardial infarction, hypertension, hyperthyroidism; prolonged use may produce
cumulative effects |
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Adverse
Reactions |
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1% to 10%: Cardiovascular: Tachycardia
<1%: Hypertension, cardiac arrhythmias, flushing, blanching of skin,
sloughing of tissue, nausea, abscess formation, diaphoresis
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Overdosage/Toxicology |
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Symptoms of overdose include hypertension, cerebral hemorrhage, cardiac
arrest, seizures |
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Drug
Interactions |
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Decreased effect with TCAs
Increased toxicity with cyclopropane, halothane, MAO inhibitors (hypertensive
crisis), digoxin, oxytocin, rauwolfia alkaloids, reserpine |
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Stability |
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Infusion solutions are stable for 24 hours; I.V. metaraminol is
incompatible when mixed with amphotericin B, dexamethasone, erythromycin,
hydrocortisone, methicillin, penicillin G, prednisolone,
thiopental |
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Mechanism of
Action |
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Stimulates alpha-adrenergic receptors to cause vasoconstriction, reflex
bradycardia, inhibits GI smooth muscle and vascular smooth muscle supplying
skeletal muscle, increases heart rate and force of heart muscle
contraction |
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Pharmacodynamics/Kinetics |
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Onset of pressor effect: I.M.: Within 10 minutes; I.V.: Within 1-2 minutes;
S.C.: Within 5-20 minutes
Elimination: Has not yet been fully elucidated |
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Usual Dosage |
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Children:
I.M.: 0.01 mg/kg as a single dose
I.V.: 0.01 mg/kg as a single dose or intravenous infusion of 5 mcg/kg/minute
Adults:
Prevention of hypotension: I.M., S.C.: 2-10 mg
Adjunctive treatment of hypotension: I.V.: 15-100 mg in 250-500 mL NS or 5%
dextrose in water
Severe shock: I.V.: 0.5-5 mg direct I.V. injection followed by intravenous
infusion of 15-100 mg in 250-500 mL NS or D5W; may also be
administered endotracheally |
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Administration |
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May be given I.M., I.V., S.C.; however, I.V. is the preferred route because
extravasation or local injection can cause necrosis; to prevent necrosis
infiltrate area with 10-15 mL of saline containing 5-10 mg of
phentolamine |
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Monitoring
Parameters |
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Blood pressure, EKG, PCWP, CVP, pulse, and urine output |
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Mental Health: Effects
on Mental Status |
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None reported |
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Mental Health:
Effects on Psychiatric
Treatment |
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Contraindicated with MAOIs; the pressor effect of direct-acting vasopressors
may be potentiated by the TCAs |
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Patient
Information |
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Since this drug is used primarily during emergencies or anesthesia
situations, patient education is supportive and situationally appropriate.
Consult prescriber if breast-feeding. |
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Dosage Forms |
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Injection, as bitartrate: 10 mg/mL (10
mL) |
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