Vasoconstrictor sympathomimetics 

EXAMPLES 
Noradrenaline, ephedrine, phenylephrine

MECHANISM OF ACTION 

  • Stimulation of peripheral a-adrenoceptors within the vasculature, leading to vasoconstriction and increased systolic and diastolic blood pressure.

INDICATIONS

  • Acute hypotension.
  • Cardiac arrest.

CAUTIONS AND CONTRA-INDICATIONS

  • Hypertension

SIDE-EFFECTS

  • Hypertension.
  • Headache.
  • Arrhythmias.
  • Bradycardia/tachycardia.

METABOLISM AND HALF-LIFE 

  • Metabolised in the liver and other tissues by MAO and COMT.

MONITORING 

  • Continuous cardiac monitoring in a high-dependency area is required.
  • Monitoring of oxygen saturation, urine output and renal function is also necessary.

DRUG INTERACTIONS

  • Severe, prolonged hypertension when given in combination with MAOIs.

IMPORTANT POINTS

  • Ephedrine can be used to treat hypotension resulting from spinal/epidural anaesthesia.