THÔNG TIN TÀI LIỆU
Phentolamine is an α-adrenergic receptor antagonist whose use should be limited to treatment of hypertension associated with catecholamine-induced hypertensive crises, as seen with pheochromocytoma or sympathomimetic toxicity Dosing recommendations vary widely Some recommend 0.05 to 0.1 mg/kg/dose intravenously to a maximum of mg, and others recommend a pediatric dose of mg administered intravenously or intramuscularly, repeated as needed to achieve appropriate blood pressure control Enalaprilat Enalaprilat is an angiotensin-converting enzyme inhibitor that can be useful in high renin states It is contraindicated for use in patients with bilateral renal artery stenosis Because of the high incidence of renovascular disease in the pediatric population, and limited pediatric experience with its use, caution must be exercised before using this agent for the treatment of severe hypertension in the ED It should be administered at a dose of 0.05 to 0.1 mg/kg intravenously up to a maximum of 1.25 mg Fenoldopam Fenoldopam is a selective dopamine agonist causing vasodilation of the renal, coronary, cerebral, and splanchnic vasculature, resulting in a decrease in mean arterial pressure The use of fenoldopam in pediatric patients has increased in recent years Its use has been reported for controlled perioperative hypotension and in the intensive care setting when conventional therapy has failed Recent reports in children showed that although fenoldopam resulted in a decrease in blood pressure levels, this required higher doses than for adults and the decrease was less than that observed in adults Peak effects are observed within 15 minutes, with steady-state serum levels achieved in 30 to 60 minutes Initial infusion rates of 0.2 to 0.8 μg/kg/min are recommended Side effects include reflex tachycardia, increased intracranial pressure, and increased intraocular pressure Although pediatric experience with fenoldopam is limited, it appears to be a reasonable alternative when more conventional therapies fail Clevidipine Clevidipine is an ultra–short-acting third-generation dihydropyridine calcium channel antagonist It has high specificity for arteriolar smooth muscle, reducing peripheral resistance while increasing stroke volume and cardiac output Its halflife is approximately minute with more rapid onset and offset than even nicardipine, which eases titration, and is metabolized in plasma, independent of
Ngày đăng: 22/10/2022, 11:23
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