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Readers ask: How is phenylephrine prepared for priapism?

Phenylephrine should be diluted in normal saline to produce a concentration of 100–500 μg/ml. Then, injections of 1 ml aliquots should be performed intracavernosally every 3–5 min for up to 1 h or up to a dose escalation of 1000 μg of diluted phenylephrine [Montague et al. 2003].

How do you mix phenylephrine for priapism?

For the injection, use a mixture of 1 ampule of phenylephrine (1 mL:1000 mcg) and dilute it with an additional 9 mL of normal saline. Using a 29-gauge needle, inject 0.3-0.5 mL into the corpora cavernosa, waiting 10-15 minutes between injections.

Can phenylephrine be used for priapism?

Studying 58 patients with 136 priapic encounters, the authors found high-dose phenylephrine to be very effective, resolving all episodes of priapism in men who presented within 36 hours of duration, with an overall resolution rate of 86%. No adverse cardiovascular symptoms or events occurred.

How does pseudoephedrine work for priapism?

An oral dose of 60-120 mg may be given in cases of priapism of short duration (2-4 h). Pseudoephedrine promotes vasoconstriction by directly stimulating alpha-adrenergic receptors.

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What is the solution to priapism?

Nonischemic priapism often goes away with no treatment. Because there isn’t a risk of damage to the penis, your doctor might suggest a watch-and-wait approach. Putting ice packs and pressure on the perineum — the region between the base of the penis and the anus — might help end the erection.

How do you dilute phenylephrine?

Phenylephrine Unimedic 10 mg/ml will be administered as an intravenous injection or infusion after dilution in sodium chloride 9 mg/ml (or glucose 50 mg/ml). – Dilution to a concentration of 100 micrograms/ml: 1 ml of the 10 mg/ml solution is diluted in 100 ml sodium chloride 9 mg/ml (or glucose 50 mg/ml).

How does terbutaline work in priapism?

The mechanism of action of terbutaline in erection is poorly understood. Although it acts as a β-2-agonist and smooth muscle relaxant, the stagnant blood in priapism would impede perfusion of the terbutaline into the corpus cavernosum, suggesting an alternate means of effect, if any.

What is phenylephrine for priapism?

The therapeutic efficacy of these agents for priapism relies on alpha receptor-mediated vasoconstriction within the corpora cavernosa. Phenylephrine is an alpha1-selective adrenergic agonist with no indirect neurotransmitter-releasing action.

Why is phenylephrine used in ischemic priapism?

Phenylephrine is the sympathomimetic of choice for treating priapism. As an α1-adrenergic receptor agonist, phenylephrine causes α-mediated vasoconstriction within the corpora cavernosa. Due to its specificity, phenylephrine has minimal cardiac side effects, which may include tachycardia, palpations and hypertension.

Where do you inject phenylephrine?

Phenylephrine Injection may be administered subcutaneously or intramuscularly in a dosage of 2 to 5 mg with further doses of 1 to 10 mg if necessary according to response, or in a dose of 100 to 500 micrograms by slow intravenous injection as a 0.1% solution, repeated as necessary after at least 15 minutes.

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Which receptor does phenylephrine stimulate?

Phenylephrine is a widely used vasopressor in the operating room for the treatment of hypotension. The primary binding target of phenylephrine is the α-adrenergic receptor with the highest affinity for the α1-receptor.

What is the antidote for phenylephrine?

Initiate phentolamine (or alternative antidote).

What kind of Sudafed is used for priapism?

If You Develop Priapism. If you have an erection at penetration hardness (a 6 or higher on the erection hardness scale) that lasts 2 hours, take 4 (30 mg) tablets of pseudoephedrine HCl (Sudafed). Don’t take extended-release or long-acting tablets, such as Sudafed 12 hour.

Can aspirin help priapism?

Administer preoperative aspirin 325 mg orally and heparin 5000 units subcutaneously to prevent clotting of the shunt and recurrence of priapism.

How much Benadryl can I take for priapism?

WARNINGS: If you experience an erection lasting more than 3.5 hours, you may take Pseudoephedrine 120 mg, and Diphenhydramine (Benadryl) 25mg by mouth once and apply an ice pack.

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