Medication 7-614 - Neo-Synephrine (Phenylephrine)

CMH EMS & MIH Protocols

Scope of Practice:

• Registered Nurse
• Paramedic
• Community Paramedic

Route(s):

• IN, Systemic IO, IV,

Pharmacodynamics (class and mechanism of action):

• Vasoconstrictor. (α (alpha) agonist. Topical vasoconstriction.).
• Systemic. IV/IO: Direct-acting alpha-adrenergic agonist with no beta-adrenergic activity; produces systemic arterial vasoconstriction. Increases systolic and diastolic blood pressure and reductions in heart rate and cardiac output

Pharmacokinetics:

• Half-life: 2.1-3.4 hours.
• Onset time: Rapid.
• Peak action time: Unknown.
• Duration of action: 0.5-4 hours.

• Peak	1	2	3	hours
  Duration	1	2	3	hours

Dosing:

• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-451 - General Trauma Management.
• Equipment 8-288 - Endotracheal Tube.
• Protocol 2-583 - Hypotension / Shock.

Contraindications:

• Hypertension.
• Thyroid disease.

Pregnancy Risk Factor:

• Category C
• Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. FDA requires a relatively large amount of high-quality data on a pharmaceutical for it to be defined as Pregnancy Category A. As a result of this, many drugs that would be considered Pregnancy Category A in other countries are allocated to Category C by the FDA.

Potential Incompatibilities:

• None.

Precautions and Adverse Effects:

• Use caution with enlarged prostate with dysuria.
• May cause nasal burning, stinging, sneezing, and/or increased nasal discharge.
• Systemic: Rebound hypertension
• Systemic: Bradycardia

Antidote:

• None.

Controlled Substance Information:

• Not a scheduled drug
• The DEA and FDA have not identified this drug with a schedule classification.
• DEA number: NA.
• Narcotic: No.
• Street names: NA.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.