Friday July 18, 2008

Q: Which very commonly use drug in ICU may increase level of Fenoldopam by 30-70% when administered concurrently ?



Answer: Acetaminophen (Tylenol or Paracetamol)

Fenoldopam is a short-acting dopamine agonist (DA1) for management of severe HTN. It increases renal blood flow and sodium excretion. It is 10 times more potent than dopamine as renal vasodilator. Initial dose is 0.1-0.3 mcg/kg/min IV and should be increased cautiously to avoid reflex tachycardia in increments of 0.05-0.1 mcg/kg/min IV q15 min until target blood pressure achieved.

Fenoldpam is relatively contraindicated or should be used with caution in patients with glaucoma and angina. It may cause hypokalemia due to diuresis. Acetaminophen may increase levels by 30-70% when administered concurrently. Also beta-blockers increase risk of hypotension.