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Ephedrine & Phenylephrine 2

Ephedrine and phenylephrine are vasopressors used to treat hypotension. Ephedrine works by activating alpha-1, beta-1, and beta-2 receptors, increasing blood pressure through vasoconstriction and raising heart rate. It is used for hypotension during surgery or anesthesia. Phenylephrine only activates alpha-1 receptors, increasing blood pressure through vasoconstriction without changing heart rate, so it is used when tachycardia needs to be avoided. Both drugs can cause hypertension as a side effect and require careful dosing and monitoring.

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Sabrina Shalhout
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267 views27 pages

Ephedrine & Phenylephrine 2

Ephedrine and phenylephrine are vasopressors used to treat hypotension. Ephedrine works by activating alpha-1, beta-1, and beta-2 receptors, increasing blood pressure through vasoconstriction and raising heart rate. It is used for hypotension during surgery or anesthesia. Phenylephrine only activates alpha-1 receptors, increasing blood pressure through vasoconstriction without changing heart rate, so it is used when tachycardia needs to be avoided. Both drugs can cause hypertension as a side effect and require careful dosing and monitoring.

Uploaded by

Sabrina Shalhout
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Ephedrine & Phenylephrine

By : Omar mohmad & Lana Hashash


Supervisor :Dr. Sana’ AL Aqqad
Ephedrine
Outline
• Family & Class

• Action

• Use & Indication

• Metabolism & Excreted

• Dose and Route

• Adverse Reactions

• Precautions &Contraindicated

• Toxicity

• Storage
Family & Class

•  Vasopressors

• Adrenergic agonist :Work in alpha 1-adrenergic receptors and beta-1 &2-


adrenergic receptors
Action
• As a direct effect:
1) activates alpha 1-adrenergic receptors : vasoconstriction a rise in blood pressure
2) activates beta-1-adrenergic receptors increases myocardial activity (contraction)
so increased HR
3) activates beta 2-adrenergic receptors. : It causes vasodilation and
bronchodilation
• As an indirect effect:
it inhibits norepinephrine reuptake and increases the release of norepinephrine from
vesicles in nerve cells, These actions combined lead to larger quantities of
norepinephrine present in the synapse for more extended periods of time, increasing
stimulation of the sympathetic nervous system.
Use & Indication

• Hypotension in surgical

• bronchial asthma

• allergic conditions

• nasal congestion
Metabolism & Excreted
• metabolized in liver

• Elimination : urine

• half-life of Po 6 hours.

• Ephedrine can cross the placental barrier.


Adverse Effects

• Cardiovascular:hypertension, palpitations, tachycardia

• Respiratory : chest pain

• Gastrointestinal: Nausea, vomiting

• Nervous system: Dizziness, restlessness


Contraindications
• hypertension or tachycardia.

• ischemic heart disease or heart failure.

• urinary retention and prostatic hyperplasia.


Route
• PO / IV / IM

• For adults, bolus dose recommendations are at 5 to 10 mg

• IM doses for a prolonged desired effect are at 25 to 50 mg.


Toxicity
• Signs and Symptoms: hypertension and convulsions. , chills, cyanosis, irritability, fever,

tachycardia, dilated pupils, blurred vision, , spasms, pulmonary edema

• Treatment: If respirations are shallow or cyanosis is present, secure the airway and provide

mechanical ventilation

• Antidote: 5 mg phentolamine mesylate diluted in saline may be administered slowly

intravenously, or clinicians may give 100 mg orally.

• Convulsions may be controlled by benzodiazepines. 


storage

• Store this medication at room temperature, (15 and 25 degrees

C). Store away from heat, moisture, and light.


Phenylephrine
Outline :

• Action

• class

• Use & Indication

• Route

• Adverse Reaction

• precautions & Contraindicated

• Toxicity

• Storage
Phenylephrine Drug Class

Phenylephrine is part of the drug class:

Sympathomimetics
Mechanism of action :

Phenylephrine is an alpha-1 adrenergic receptor agonist indicated for the treatment of

clinically important hypotension resulting primarily from vasodilation in the setting of

anesthesia.

Phenylephrine is used to relieve nasal discomfort caused by colds, allergies, and hay

fever. It is also used to relieve sinus congestion and pressure. It works by reducing

swelling of the blood vessels in the nasal passages.


Uses of
🞂 Topical:

Phenylephrine ophthalmic solution is a prescription medication used to dilate (widen)

the pupils prior to examinations or surgical procedures of the eye.

🞂 Injectable:

Phenylephrine for injection is a prescription medication used to increase blood pressure

during surgical procedures requiring anesthesia.


Administration :

• The most common routes of administration for phenylephrine include oral,

topical, intravenous, intranasal, ophthalmic, and rectal.

• Less commonly, phenylephrine has been administered in the epidural space.

• When administering phenylephrine intravenously, dosing is typically in 50 to

100 mcg.
Duration
The onset of action was within 15 to 20 minutes with the effect lasting 2-4

hours.
side effects :
 signs of an allergic reaction: difficulty breathing; swelling of your face, lips,
tongue, or throat.
• severe dizziness or nervousness
• sleep problems (insomnia)
• increased blood pressure
• severe headache
• blurred vision
• flushing (warmth, redness, or tingly feeling)
• loss of appetite
• feeling restless or excited (especially in children).
Contraindications :

Phenylephrine use requires caution in patients with a history of bradycardia,

autonomic dysfunction, severe cardiac dysfunction, and hypovolemia.


precautions
Before taking phenylephrine
 if you are allergic to phenylephrine, any other medications, or any of the
ingredients in phenylephrine preparations.
tell your doctor and pharmacist what other prescription and
nonprescription medications, vitamins, nutritional supplements, and
herbal products you are taking or plan to take.
 if you have or have ever had high blood pressure, diabetes, trouble
urinating because of an enlarged prostate gland, or thyroid or heart
disease
Toxicity

🞂 Currently, there is no available antidote for intravenous phenylephrine.

🞂 Hypertension in the setting of excessive dosing or an exaggerated response is usually

short-lived due to the short duration of action.

🞂 The treatment for hypertension or symptomatic reflex bradycardia is discontinuing

the administration of phenylephrine and chronotropic agents or vasodilators as needed.


Storage

• at 20°C to 25°C (68°F to 77°F), excursions permitted to 15°C to

30°C (59°F to 86°F)


Question
when patent hypotension At any time used :

• Ephedrine : when Bradycardia & hypotension

• Phenylephrine: Tachycardia & hypotension


Reference
• https://go.drugbank.com/drugs/DB01364
• https://www.drugs.com/ephedrine.html
• https://
www.uptodate.com/contents/ephedrine-systemic-drug-information?sear
ch=Ephedrine%20&source=panel_search_result&selectedTitle=1~127&usa
ge_type=panel&kp_tab=drug_general&display_rank=1
• https://www.ncbi.nlm.nih.gov/books/NBK547661/
• https://www.rxlist.com/ephedrine-drug.htm#dosage
• https://
www.uptodate.com/contents/hemodynamic-management-during-anesth
esia-in-adults
•

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