Necrotizing Properties of Metaraminol (Aramine) and Arterenol (Norepinephrine)

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Abstract
Two vasopressors currently used in the treatment of various acute hypotensive states are metaraminol (Aramine;l-1-[m-hydroxyphenyl]-2-amino-1-propanol) and levarterenol (Levophed;l-norepinephrine). The cardiovascular and renal hemodynamics of these two drugs have been extensively studied by many investigators, both clinically and in experimental animals.1-3Their local effects on the soft tissues, when administered intravenously or subcutaneously, have received inadequate attention, although in many patients the local necrotizing properties of various vasoconstrictors have been distressingly obvious.4 In a previous report,5it was shown that soft-tissue sloughs associated with the intravenous administration of solutions containing arterenol were apparently due to extravascular infiltration of the solution. In addition, it was demonstrated that "Levophed sloughs" could be prevented by injecting phentolamine (Regitine) into and about the margins of the extravasation. Moyer6and others7,8have not observed deleterious local effects from the infiltration of soft tissue by solutions

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