A year after FDA approval in heart failure (HF) with LVEF of 40% or higher, new ACC guidance and trial subanalyses are shaping how pharmacists use finerenone.
|Articles|July 27, 2022
Daily Medication Pearl: Angiotensin II (Giapreza) Injection
Author(s)Saro Arakelians, PharmD
Angiotensin II (Giapreza) is a vasoconstrictor to increase blood pressure in adults with septic or other distributive shock.
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Medication Pearl of the Day: Angiotensin II (Giapreza) Injection
Indication: Angiotensin II (Giapreza) is a vasoconstrictor to increase blood pressure in adults with septic or other distributive shock.
Insight:
- Dosing: Start angiotensin II 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.
- Dosage forms: Injection 2.5 mg/mL and 5 mg/2 mL (2.5 mg/mL) in a vial.
- Adverse events: The most common adverse reactions reported in greater than 10% in patients administered angiotensin II were thromboembolic events.
- Mechanism of action: 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 Ca2+/calmodulin-dependent phosphorylation of myosin and causes smooth muscle contraction.
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