Phentolamine Injection

What is Phentolamine Injection?
Phentolamine Injection is a potent non-selective alpha-adrenergic blocker. It is a specialized critical care medication used to block the effects of adrenaline and noradrenaline in the body. It is an essential tool in surgical settings for managing sudden, dangerous spikes in blood pressure and in clinical settings to prevent severe tissue damage caused by the leakage (extravasation) of certain intravenous medications.
Uses of Phentolamine Injection
Pheochromocytoma: Prevention and management of hypertensive crises before or during the surgical removal of an adrenal gland tumor.
Norepinephrine Extravasation: Prevention of dermal necrosis and sloughing following the leakage of intravenous norepinephrine or dopamine into surrounding tissue.
Hypertensive Urgency: Rapid reduction of blood pressure caused by high levels of circulating catecholamines.
Diagnosis of Pheochromocytoma: Historically used as a diagnostic tool (phentolamine blocking test).
Reversal of Local Anesthesia: Used in dental procedures (as Phentolamine Mesylate) to reverse soft-tissue anesthesia and return normal sensation.
How Does Phentolamine Injection Work?
Phentolamine works by competitively blocking alpha-1 and alpha-2 adrenergic receptors. By preventing catecholamines (like adrenaline) from binding to these receptors on the walls of blood vessels, it causes the vessels to relax and widen (vasodilation). This results in an immediate decrease in peripheral vascular resistance and a significant drop in blood pressure. When injected into skin tissue after a medication leak, it restores blood flow to the area, preventing the tissue from dying.
FAQs on Phentolamine Injection
1. How is Phentolamine administered for tissue leakage (extravasation)? For extravasation, Phentolamine is diluted with saline and injected subcutaneously in small amounts around the affected area where the IV leak occurred. This should be done as soon as possible, ideally within 12 hours of the incident, to be most effective.
2. What monitoring is required during intravenous use? Because Phentolamine acts rapidly on the cardiovascular system, continuous monitoring of blood pressure and heart rate is mandatory. It can cause a sudden drop in blood pressure (hypotension) or an increase in heart rate (tachycardia).
3. Can it be used for routine high blood pressure? No. Phentolamine is reserved for specific medical emergencies and surgical conditions related to catecholamine excess. It is not intended for the long-term management of chronic hypertension.
Therapeutic Category
Cardiovascular (Alpha-Adrenergic Blocker)
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