Angiotensin II
What is Angiotensin II?[edit | edit source]
- Angiotensin II (GIAPREZA) is a vasoconstrictor used to treat hypotension resulting from septic shock or other distributive shock.
What are the uses of this medicine?[edit | edit source]
This medicine is used to increases blood pressure in adults with septic or other distributive shock.
How does this medicine work?[edit | edit source]
- Angiotensin II raises blood pressure by vasoconstriction and increased aldosterone release.
- Direct action of angiotensin II on the vessel wall is mediated by binding to the G-protein-coupled angiotensin II receptor type 1 on vascular smooth muscle cells, which stimulates Ca 2+/calmodulin-dependent phosphorylation of myosin and causes smooth muscle contraction.
Who Should Not Use this medicine ?[edit | edit source]
- This medcine have no usage limitations.
What drug interactions can this medicine cause?[edit | edit source]
- Avoid Concomitant use of GIAPREZA with angiotensin converting enzyme (ACE) inhibitors as it may increase the response to GIAPREZA.
- Avoid Concomitant use of GIAPREZA with angiotensin II receptor blockers (ARBs) as it may decrease the response to GIAPREZA.
Is this medicine FDA approved?[edit | edit source]
- It was approved for use in the United States in 2017.
How should this medicine be used?[edit | edit source]
Recommended Dosage
- Start GIAPREZA intravenously at 20 nanograms (ng)/kg/min.
- Titrate as frequently as every 5 minutes by increments of up to 15 ng/kg/min as needed.
- During the first 3 hours, the maximum dose should not exceed 80 ng/kg/min.
- Maintenance dose should not exceed 40 ng/kg/min.
- Doses as low as 1.25 ng/kg/min may be used.
- Dilute GIAPREZA in 0.9% sodium chloride prior to use.
- Diluted solution may be stored at room temperature or under refrigeration and should be discarded after 24 hours.
Administration
- The recommended starting dosage of GIAPREZA is 20 nanograms (ng)/kg/min via continuous intravenous infusion.
- Administration through a central venous line is recommended.
- Monitor blood pressure response and titrate GIAPREZA as frequently as every 5 minutes by increments of up to 15 ng/kg/min as needed to achieve or maintain target blood pressure.
- Do not exceed 80 ng/kg/min during the first 3 hours of treatment.
- Maintenance dose should not exceed 40 ng/kg/min. Doses as low as 1.25 ng/kg/min may be used.
- Once the underlying shock has sufficiently improved, down-titrate every 5 to 15 minutes by increments of up to 15 ng/kg/min based on blood pressure.
What are the dosage forms and brand names of this medicine?[edit | edit source]
This medicine is available in fallowing doasage form:
- As Injection: 2.5 mg/mL in a vial.
This medicine is available in fallowing brand namesː
- GIAPREZA
What side effects can this medication cause?[edit | edit source]
The most common side effects of this medicine include:
- thromboembolic events
- Deep vein thrombosis
- Thrombocytopenia
- Tachycardia
- Fungal infection
- Delirium
- Acidosis
- Hyperglycemia
- Peripheral ischemia
What special precautions should I follow?[edit | edit source]
There was a higher incidence of arterial and venous thrombotic and thromboembolic events in patients who received GIAPREZA. Use concurrent venous thromboembolism (VTE) prophylaxis.
What to do in case of emergency/overdose?[edit | edit source]
- Overdose of GIAPREZA would be expected to result in hypertension, necessitating close monitoring and supportive care.
- Effects are expected to be brief because the half-life of angiotensin II is less than one minute.
Can this medicine be used in pregnancy?[edit | edit source]
- The published data on angiotensin II use in pregnant women are not sufficient to determine a drug-associated risk of adverse developmental outcomes.
Can this medicine be used in children?[edit | edit source]
- The safety and efficacy of GIAPREZA in pediatric patients have not been established.
What are the active and inactive ingredients in this medicine?[edit | edit source]
Active ingredient:
- ANGIOTENSIN II
Inactive ingredients:
- MANNITOL
- WATER
- SODIUM HYDROXIDE
- HYDROCHLORIC ACID
Who manufactures and distributes this medicine?[edit | edit source]
- Packager: La Jolla Pharmaceutical Company
What should I know about storage and disposal of this medication?[edit | edit source]
- GIAPREZA vials should be stored in the refrigerator (36-46°F, 2-8°C).
- Discard prepared diluted solution after 24 hours at room temperature or under refrigeration.
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Contributors: Deepika vegiraju