Fenoldopam
Mechanism :
A selective postsynaptic dopamine agonist (D1-receptors) which exerts hypotensive effects by decreasing peripheral vasculature resistance with increased renal blood flow, diuresis, and natriuresis; 6 times as potent as dopamine in producing renal vasodilatation; has minimal adrenergic effects.
Indication :
Contraindications :
No contraindications.
Dosing :
Severe hypertension: IV:
Initial: 0.2 mcg/kg/minute; may increase in increments of 0.3 to 0.5 mcg/kg/minute every 20 to 30 minutes (Maximum dose: 0.8 mcg/kg/minute); limit for short-term (4 hours) use.
Adverse Effect :
Flushing, hypotension, headache, nausea, angina pectoris, bradycardia, cardiac failure, chest pain, ECG abnormality (ST-T abnormalities), extrasystoles, inversion T wave on ECG, myocardial infarction, orthostatic hypotension, palpitations, tachycardia, anxiety, dizziness, insomnia, hyperglycemia, hypokalemia, increased lactate dehydrogenase, hemorrhage, leucocytosis, increased serum transaminases, increased blood urea nitrogen, increased serum creatinine.
Interaction :
Amphetamines: May diminish the antihypertensive effect of Antihypertensive Agents.
Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect.
Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents.
Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents.
Hepatic Dose :
No dose adjustments are suggested. However, drug adjustment will be needed for pediatric population.