[fen-ill-EF-rin] Pregnancy Category: C Nasal: Alconefrin 12, 25, and 50, Children's Nostril, Doktors, Duration, Neo-Synephrine Solution, Nostril, Rhinall, Vicks Sinex. Ophthalmic: AK-Dilate, Dionephrine M, Mydfrin 2.5%, Neo-Synephrine, Neo-Synephrine Viscous, Phenoptic, Prefrin Liquifilm, Relief. Parenteral: Neo-Synephrine. (Rx: Parenteral and Ophthalmic Solutions 2.5% or greater; OTC: Nasal products and ophthalmic solutions 0.12% or less)
Classification: Alpha-adrenergic agent (sympathomimetic)
See also Sympathomimetic Drugs and Nasal Decongestants. Action/Kinetics: Stimulates alpha-adrenergic receptors, producing pronounced vasoconstriction and hence an increase in both SBP and DBP; reflex bradycardia results from increased vagal activity. Also acts on alpha receptors producing vasoconstriction in the skin, mucous membranes, and the mucosa as well as my-driasis by contracting the dilator muscle of the pupil. IV: Onset, immediate; duration, 15-20 min. IM, SC: Onset, 10-15 min; duration: 0.5-2 hr for IM and 50-60 min for SC. Nasal decongestion (topical): Onset: 15-20 min; duration, 30 min-4 hr. Ophthalmic: Time to peak effect for mydriasis, 15-60 min for 2.5% solution and 10-90 min for 10% solution. Duration: 0.5-1.5 hr for 0.12%, 3 hr for 2.5%, and 5-7 hr with 10% (when used for mydriasis). Excreted in urine.
Uses: Systemic: Vascular failure in shock, shock-like states, drug-induced hypotension or hypersensitiv-ity. To maintain BP during spinal and inhalation anesthesia; to prolong spinal anesthesia. As a vasoconstrictor in regional analgesia. Paroxysmal SVT. Nasal: Nasal congestion due to allergies, sinusitis, common cold, or hay fever. Ophthal-mologic: 0.12%: Temporary relief of redness of the eye associated with colds, hay fever, wind, dust, sun, smog, smoke, contact lens. 2.5% and 10%: Decongestant and vasoconstrictor, treatment of uveitis with posterior synechiae, open-angle glaucoma, refraction without cyclople-gia, ophthalmoscopic examination, funduscopy, prior to surgery. Contraindications: Severe hypertension, ventricular tachycardia. Special Concerns: Use with extreme caution in geriatric clients, severe arteriosclerosis, bradycardia, partial heart block, myocardial disease, hyperthyroidism and during pregnancy and lactation. Nasal and ophthalmic use of phenylephrine may be systemically absorbed. Use of the 2.5% or 10% ophthalmic solu tions in children may cause hypertension and irregular heart beat. In geriatric clients, chronic use of the 2.5% or 10% ophthalmic solutions may cause rebound miosis and a decreased mydriatic effect. Side Effects: CV: Reflex bradycar-dia, arrhythmias (rare). CNS: Headache, excitability, restlessness. Oph-thalmologic: Rebound miosis and decreased mydriatic response in geriatric clients, blurred vision.
Additional Drug Interactions Anesthetics, halogenated hydrocarbon / May sensitize myocardium ^ serious arrhythmias How Supplied: Injection: 10 mg/mL; Liquid: 5 mg/5 mL; Nasal solution: 0.125%, 0.25%, 0.5%, 1%; Ophthalmic solution: 0.12%, 2.5%, 10%; Nasal spray: 0.25%, 0.5%, 1%
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