Yes

Alpha₁ Agonist

Acute hypotensive crisis in the treatment of shock

D

Hypersensitivity to metaraminol or any component, cyclopropane or halothane anesthesia, or MAO inhibitors

Can cause cardiac arrhythmias; use with caution in patients with a previous myocardial infarction, hypertension, hyperthyroidism; prolonged use may produce cumulative effects

1% to 10%: Cardiovascular: Tachycardia

<1%: Hypertension, cardiac arrhythmias, flushing, blanching of skin, sloughing of tissue, nausea, abscess formation, diaphoresis

Symptoms of overdose include hypertension, cerebral hemorrhage, cardiac arrest, seizures

Decreased effect with TCAs

Increased toxicity with cyclopropane, halothane, MAO inhibitors (hypertensive crisis), digoxin, oxytocin, rauwolfia alkaloids, reserpine

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

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

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

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

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

Blood pressure, EKG, PCWP, CVP, pulse, and urine output

None reported

Contraindicated with MAOIs; the pressor effect of direct-acting vasopressors may be potentiated by the TCAs

Since this drug is used primarily during emergencies or anesthesia situations, patient education is supportive and situationally appropriate. Consult prescriber if breast-feeding.

Injection, as bitartrate: 10 mg/mL (10 mL)