| Name: |
PHENTOLAMINE (RogitineR) |
| Classification: |
alpha antagonist; vasodilator
- alpha blockade in pheochromocytoma (used with a beta blocker)
- antidote for extravasation of alpha stimulants
- antihypertensive agent
- afterload reduction
- useful to treat hypertension in MAO-I overdose
|
| Dose: |
- Bolus dose:
- Infusion:
- Antidote for vasoconstrictor extravasation:
- 5-15mg in 10 mL NS infiltrated into the area of extravasation as soon as possible; may be effective up to 12 hours post extravasation of vasoconstrictor
- administer initial dose into interstitial catheter prior to removal to direct phentolamine into area of infiltration
- anticipate need for increased sympathomimetic therapy and/or volume therapy
|
| Administration: |
IV Infusion:
300mg/500mL D5W, NS RL
- should be weaned off
- treat hypovolemia concurrently with initiation of drug therapy
- For pheochromocytoma blockade - initiate phentolamine prior to commencing beta blockade; beta blockade may increase peripheral vasoconstriction and worsen hypertension
|
| Adverse Effects: |
- hypotension
- hypovolemia
- tachycardias
- arrhythmias
- increased gastric acid secretion
- tachyphylaxis may occur
|
| Drug Interactions: |
- phentolamine + alpha adrenergic agents = decreased alpha effects
|
| Monitoring Therapy: |
- BP
- HR, ECG
- urine output
- cardiac index
- PWP
- SVRI, PVRI
- arterial lactate
|
| CCTC Protocol: |
- May be administered by IV infusion or IV direct by an approved nurse in CCTC.
- May be titrated by an approved nurse in CCTC.
- Preferable to administer via a central line.
- Continuous infusion must be administered via an infusion pump.
- Should not be infused via proximal injectate port (blue) of the Swan Ganz catheter.
- Patient requires placement of an arterial line to monitor BP.
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