Metaraminol (Aramine)

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

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