▶With intravenous use For intravenous infusion dilute to a
concentration of 200 nanograms/mL with Glucose 5% or
Sodium Chloride 0.9%; alternatively, may be diluted to a
concentration of 2 micrograms/mL and given via syringe
driver.
▶When used by inhalation To minimise accidental exposure
use only with nebulisers listed in product literature in a
well ventilated room.
PDF page 220
There can be variation in the licensing of
different medicines containing the same drug.
Solution for infusion
EXCIPIENTS: May contain Ethanol
▶Iloprost (Non-proprietary)
Iloprost (as Iloprost trometamol) 100 microgram per
1 ml Iloprost 100micrograms/1ml solution for infusion ampoules |
1 ampoule P s
Iloprost 50micrograms/0.5ml concentrate for solution for infusion
ampoules | 1 ampoule P £75.00 (Hospital only) |
5 ampoule P £300.00 (Hospital only)
Nebuliser liquid
EXCIPIENTS: May contain Ethanol
▶Iloprost (Non-proprietary)
Iloprost (as Iloprost trometamol) 10 microgram per 1 ml Iloprost
10micrograms/1ml nebuliser liquid ampoules | 30 ampoule P
£300.00 | 160 ampoule P £1,700.00
▶Ventavis (Bayer Plc)
Iloprost (as Iloprost trometamol) 10 microgram per 1 ml Ventavis
10micrograms/ml nebuliser solution 1ml ampoules |
42 ampoule P £560.27 | 168 ampoule P £2,241.08
Ventavis 10micrograms/ml nebuliser solution 1ml ampoules with
Breelib | 168 ampoule P £2,241.08
Iloprost (as Iloprost trometamol) 20 microgram per 1 ml Ventavis
20micrograms/ml nebuliser solution 1ml ampoules |
42 ampoule P £560.27
Iloprost (as Iloprost trometamol) 20 microgram per 1 ml Ventavis
20micrograms/ml nebuliser solution 1ml ampoules with Breelib |
168 ampoule P £2,241.08
4.2 Hypotension and shock
Sympathomimetics
Inotropic sympathomimetics
Shock
Shock is a medical emergency associated with a high
mortality. The underlying causes of shock such as
haemorrhage, sepsis, or myocardial insufficiency should be
corrected. The profound hypotension of shock must be
treated promptly to prevent tissue hypoxia and organ failure.
Volume replacement is essential to correct the hypovolaemia
associated with haemorrhage and sepsis but may be
detrimental in cardiogenic shock. Depending on
haemodynamic status, cardiac output may be improved by
the use of sympathomimetic inotropes such as
adrenaline/epinephrine p. 236, dobutamine p. 235 or
dopamine hydrochloride p. 199. In septic shock, when fluid
replacement and inotropic support fail to maintain blood
pressure, the vasoconstrictor noradrenaline/norepinephrine
p. 200 may be considered. In cardiogenic shock peripheral
resistance is frequently high and to raise it further may
worsen myocardial performance and exacerbate tissue
ischaemia.
The use of sympathomimetic inotropes and
vasoconstrictors should preferably be confined to the
intensive care setting and undertaken with invasive
haemodynamic monitoring.
See also advice on the management of anaphylactic shock
in Antihistamines, allergen immunotherapy and allergic
emergencies p. 291.
Vasoconstrictor sympathomimetics
Vasoconstrictor sympathomimetics raise blood pressure
transiently by acting on alpha-adrenergic receptors to
constrict peripheral vessels. They are sometimes used as an
emergency method of elevating blood pressure where other
measures have failed.
The danger of vasoconstrictors is that although they raise
blood pressure they also reduce perfusion of vital organs
such as the kidney.
Spinal and epidural anaesthesia may result in sympathetic
block with resultant hypotension. Management may include
intravenous fluids (which are usually given prophylactically),
oxygen, elevation of the legs, and injection of a pressor drug
such as ephedrine hydrochloride p. 286. As well as
constricting peripheral vessels ephedrine hydrochloride also
accelerates the heart rate (by acting on beta receptors). Use
is made of this dual action of ephedrine hydrochloride to
manage associated bradycardia (although intravenous
injection of atropine sulfate p. 1404 may also be required if
bradycardia persists).
SYMPATHOMIMETICS › INOTROPIC
PDF pages 220, 221
