Home Drug Guide Fenoldopam Mesylate

Drug Guide

Generic Name

Fenoldopam Mesylate

Brand Names Corlopam

Classification

Therapeutic: Antihypertensive

Pharmacological: Dopamine D1 receptor agonist

FDA Approved Indications

  • Hypertensive emergencies

Mechanism of Action

Fenoldopam selectively activates dopamine D1 receptors in renal, mesenteric, coronary, and peripheral vasculature, leading to vasodilation and a reduction in blood pressure. It also increases renal perfusion without significantly affecting heart rate or cardiac output.

Dosage and Administration

Adult: Initial dose: 0.1 micrograms/kg/min IV infusion, titrated up to 0.3 micrograms/kg/min as needed to control blood pressure.

Pediatric: Use not established; limited data available.

Geriatric: Start at lower doses due to potential increased sensitivity.

Renal Impairment: Adjustments generally not required; monitor blood pressure closely.

Hepatic Impairment: Data limited; use with caution.

Pharmacokinetics

Absorption: Administered IV; rapid onset.

Distribution: Widely distributed, crosses placental barrier.

Metabolism: Primarily hepatic metabolism.

Excretion: Excreted in urine as metabolites.

Half Life: Approximate half-life is 10 minutes.

Contraindications

  • Known hypersensitivity to fenoldopam or other components.
  • Concurrent use of linezolid (due to MAO inhibitory effects).

Precautions

  • Use with caution in patients with increased intracranial pressure, angle-closure glaucoma, or during pregnancy/lactation.

Adverse Reactions - Common

  • Reflex tachycardia (Common)
  • Headache (Common)
  • Nausea (Common)
  • Hypotension (Common)

Adverse Reactions - Serious

  • Allergic reactions including rash, pruritus, bronchospasm (Rare)
  • Increased intraocular pressure (Rare)

Drug-Drug Interactions

  • MAO inhibitors (e.g., linezolid), which can enhance hypotensive effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure continuously during infusion. Assess renal function periodically.

Diagnoses:

  • Risk for decreased cardiac output related to hypotension.
  • Knowledge deficit regarding medication purpose and effects.

Implementation: Administer via infusion pump, titrate carefully to desired blood pressure. Ensure continuous blood pressure monitoring.

Evaluation: Assess effectiveness by sustained reduction in blood pressure without significant adverse effects.

Patient/Family Teaching

  • Do not stop medication abruptly.
  • Report any symptoms of headache, dizziness, or excessive hypotension.
  • Attend follow-up appointments for blood pressure monitoring.

Special Considerations

Black Box Warnings:

  • None at this time.

Genetic Factors: Limited data.

Lab Test Interference: May affect laboratory measurements indirectly by changing physiological parameters.

Overdose Management

Signs/Symptoms: Excessive hypotension, reflex tachycardia.

Treatment: Discontinue infusion immediately. Supportive measures include elevating the legs, administering IV fluids, and using vasoconstrictors if necessary.

Storage and Handling

Storage: Store at controlled room temperature, 20-25°C (68-77°F).

Stability: Stable under proper storage conditions; use within specified time after preparation.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.