Pharm 101: Metaraminol

Class

Vasopressor

Pharmacodynamics
  • Synthetic sympathomimetic
  • Direct and indirect (via noradrenaline release) alpha 1 receptor agonist
  • Organ system effects:
    • Vasoconstriction: increases SVR/PVR, increases BP
    • Reflex bradycardia
    • Cardiac output either unchanged or decreased
    • Indirect increase in coronary artery flow
    • Reduced blood flow to viscera, kidneys, skin
Pharmacokinetics
  • IV administration
  • Onset of action 1-2 minutes
  • Duration of action 20-60 minutes
  • Half-life: minutes
Clinical uses
  • IV administration:
    • Bolus 0.5-2 mg
    • Infusion 0.5-10 mg/hr titrated to BP parameters
  • Shock:
    • Temporising measure whilst other treatment instituted (fluids etc.)
  • Sympathetic nervous system failure e.g. spinal injury or anaesthesia
Adverse effects
  • Bradycardia (reflex)
  • Arrhythmias
References
  • Forrest P. Vasopressors. Royal Prince Alfred Hospital, Sydney, Australia.
  • Better Safe Care Victoria. Clinical Guideline: Metaraminol. Melbourne, Australia.
  • Katzung BG. Basic & Clinical Pharmacology. 14th ed. United States of America: McGraw-Hill Education; 2018. 149 p.
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MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner

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