Metaraminol
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Metaraminol, previously sold under the brand name Aramine among others and also known as metaradrine, is a
stereoisomer In stereochemistry, stereoisomerism, or spatial isomerism, is a form of isomerism in which molecules have the same molecular formula and sequence of bonded atoms (constitution), but differ in the three-dimensional orientations of their atoms in ...
of ''meta''-hydroxynorephedrine (3,β-dihydroxyamphetamine), is a potent
sympathomimetic amine Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system. Examples of sympathomimetic effects include increases in heart ...
used in the prevention and treatment of
hypotension Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure (the top number) and the dia ...
, particularly as a complication of anesthesia. It is an α1-adrenergic receptor agonist with some β effect. It is currently sold in its generic form by Slayback Pharma.


Pharmacology and use as a vasopressor

Metaraminol is given
intravenously Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrie ...
as either a bolus (often 0.5-1mg doses) or as an infusion, usually via peripheral intravenous access. Metaraminol is commonly available as 10mg in 1mL, that requires dilution prior to administration (often made up to a 0.5mg/mL solution), however pre-prepared syringes of metaraminol for bolus use for hypotension are also commonly available.


Pharmacodynamics

The dominant mechanism for the vasopressor action of metaraminol is indirect, with metaraminol displacing
noradrenaline Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter. The name "noradrenaline" (from Latin '' ad'', ...
from neuronal vesicles in order for the noradrenaline to exert its vasopressor action. Metaraminol at higher doses may have direct alpha-adrenergic agonist and beta-1 adrenergic agonist effects. However at doses common in clinical practice, the indirect alpha-1 adrenergic effects predominate, such that
reflex bradycardia Reflex bradycardia is a bradycardia (decrease in heart rate) in response to the baroreceptor reflex, one of the body's homeostatic mechanisms for preventing abnormal increases in blood pressure. In the presence of high mean arterial pressure, t ...
is a common side-effect.


Research

Metaraminol is also used in the treatment of priapism.


References


External links

* * Alpha-1 adrenergic receptor agonists Beta-adrenergic agonists Cardiac stimulants Phenylethanolamines Phenols Substituted amphetamines {{cardiovascular-drug-stub