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Phenylephrine is a selective α 1-adrenergic receptor agonist with minimal to no β-adrenergic receptor agonist activity or induction of norepinephrine release. [5] [8] [15] It causes constriction of both arteries and veins. [12] Phenylephrine was patented in 1933 [16] and came into medical use in 1938. [17] It is available as a generic medication.
Medications such as clonidine and dexmedetomidine target pre-synaptic auto receptors, therefore leading to an overall decrease in norepinephrine which clinically can cause effects such as sedation, analgesia, lowering of blood pressure and bradycardia. There is also low quality evidence that they can reduce shivering post operatively.
The mechanisms of sympathomimetic drugs can be direct-acting (direct interaction between drug and receptor), such as α-adrenergic agonists, β-adrenergic agonists, and dopaminergic agonists; or indirect-acting (interaction not between drug and receptor), such as MAOIs, COMT inhibitors, release stimulants, and reuptake inhibitors that increase the levels of endogenous catecholamines.
Phenylephrine is found in a wide range of cold and flu medications, including Sudafed PE, Benadryl Allergy D Plus Sinus and Vicks DayQuil Cold and Flu Relief. Here’s what experts say are ...
Oral phenylephrine is ineffective and “should almost never be used,” said Dr. Purvi Parikh, an allergist and immunologist at Allergy & Asthma Associates of Murray Hill in New York City.
Conversely, hypertension or tachycardia can be treated with short-acting antihypertensive drugs such as nitroprusside or esmolol; longer acting drugs such as propranolol should be avoided as they may lead to hypotension and shock. [6] The cause of serotonin toxicity or accumulation is an important factor in determining the course of treatment.
Tachycardia secondary to peripheral vasodilation and cardiac stimulation (Such tachycardia may be accompanied by palpitations.) [4] Tremor, excessive sweating, anxiety, insomnia, and agitation [5] More severe effects include paradoxical bronchospasm, hypokalemia, and in rare cases a myocardial infarction. [4]
Tachycardia describes an abnormally rapid heart rate. By stringing these words together, you can see that POTS is a description of symptoms that commonly occur together, otherwise known as a ...