Extravasation of pressors in ICU

Q; All of the pressors in ICU may respond to local area antidote treatment with phentolamine in case of extravasation except?

A) Phenylephrine
B) Norepinephrine
C) Epinephrine
D) Vasopressin
E) Dopamine


Answer: D

Local extravasation of pressors may cause ischemia in the area and can have a morbid long term effect.

Norepinephrine, epinephrine, and dopamine have affinities for both the alpha and beta receptors. Phenylephrine is a pure alpha1 agonist. They all need treatment in case of extravasation. Vasopressin exerts vasoconstriction via V1 receptors and may not respond to treatment with phentolamine, an antidote for such scenarios.

#toxicology


Reference:

Plum, M., & Moukhachen, O. (2017). Alternative Pharmacological Management of Vasopressor Extravasation in the Absence of Phentolamine. P & T : a peer-reviewed journal for formulary management, 42(9), 581-592.