- Metaraminol is a sympathomimetic, adrenoceptor stimulant.
- It directly and indirectly stimulates the alpha receptors in the sympathetic nervous system.
- Alpha stimulation causes vasoconstriction with an increase in both systolic and diastolic blood pressure and an increase in systemic vascular resistance.
- It has a positive inotropic effect on the heart and a peripheral vasoconstrictor action
- Onset: 1 to 2 minutes; Duration: 20-60 minutes; Half-life: minutes
- Adjunctive treatment of hypotension after adequate fluid resuscitation due to:
- Haemorrhage
- Cardiogenic shock
- Septicaemia
- Reactions to medications
- Shock associated with brain damage due to trauma
- Prevention and treatment of the acute hypotensive state occurring with anaesthesia
- Hypersensitivity.
- Hypovolaemia
- MAOIs or within 14 days of such treatment
- Use of Metaraminol with (MAOI’s) or tricyclic antidepressants may result in potentiation of the pressor effect.
- Hypotension can be defined as less than 30% of the patient's base line SBP or for children (1-10 years): 70 mmHg +(2 x age).
- Extravasation may cause tissue necrosis
- Asthma – increased risk of allergy to sulfites (sodium metabisulfite is an excipient)
- May increase risk of arrhythmias if given with other arrhythmogenic medications (e.g. digoxin)
- Use with caution in the presence of heart or thyroid disease, hypertension or diabetes
| kg | ||
| Mode: | ||
| Weight: | ||
IV Metaraminol for IV/IO
IV Metaraminol for infusion
- ASMA Consult required
Adult:
- IV/IO:
- IV/IO 0.5mg - 1mg, repeat >3 min
- Dilute 10mg/1ml into 20ml NaCl 0.9% to provide a solution of 0.5mg/ml.
- Infusion:
- 20mg in 50ml in NaCl 0.9% at 0.5 to 5 ml/hr (0.4mg/ml) titrate to BP/haemodynamic status
| Dose Range | Rate of infusion (SD) |
|---|---|
| 0.05μg/kg/min | 0.5mL/hr |
| 0.1μg/kg/min | 1mL/hr |
| 0.2μg/kg/min | 2mL/hr |
| 0.3μg/kg/min | 3mL/hr |
| 0.4μg/kg/min | 4mL/hr |
| 0.5μg/kg/min | 5mL/hr |
Paediatric:
- IV/IO:
- 0.01mg/kg, repeat >3 min
- Dilute 5mg/0.5ml into 50ml normal saline to provide solution of 0.1mg/ml
- Infusion:
- 0.15mg/kg in 50ml in normal saline at 1 to 10 ml/hr (0.05-0.5mcg/kg/min)
- Titrate to BP / haemodynamic status.
| Weight | Dose |
|---|---|
| 5kg | 0.75mg |
| 10kg | 1.5mg |
| 15kg | 2.25mg |
| 20kg | 3mg |
| 30kg | 4.5mg |
| 40kg | 6mg |
| 50kg | 7.5mg |
| Dose Range | Rate of infusion (SD) |
|---|---|
| 0.05μg/kg/min | 1mL/hr |
| 0.1μg/kg/min | 2mL/hr |
| 0.2μg/kg/min | 4mL/hr |
| 0.5μg/kg/min | 10mL/hr |
Administer dose cautiously as rapidly induced hypertensive response may cause:
- Arrhythmias
- Pulmonary oedema
- Cerebral haemorrhage
- Cardiac arrest.
Causes tissue necrosis, avoid extravasation.
| Settings | |
|---|---|
| Current mode: | |
| Extended Care: | |
| Colour assist: | |
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