Myomine 200 mg/5 ml (IV Injection)

Indications

• Correction of haemodynamic imbalance
• Treatment of acute hypotension or shock
• Adjunct after open heart surgery
• Chronic cardiac decompensation
• Congestive failure

Pharmacology

• Stimulation of alpha, beta, and dopamine receptors
• Positive chronotropic and inotropic effects on the myocardium
• Increased heart rate and cardiac contractility
• Indirect release of norepinephrine from sympathetic nerve endings
• No activation of dopamine receptors in the brain

Dosage

• Adult dose administration guidelines
• Children under 12 years old dosage
• Dosage for severe, refractory, chronic congestive heart failure
• Monitoring instructions for ECG, blood pressure, and urine output
• Geriatric patients dosage and monitoring

Administration

• Intravenous administration through suitable intravenous catheter or needle
• Use of intravenous drip chamber for controlling rate of flow
• Individual titration for desired haemodynamic and renal response
• Adjustment of drug concentration for unnecessary fluid expansion
• Safe usage rate in advanced circulatory decompensation states

Interaction

• Potentiation by monoamine oxidase inhibitors (MAOI's)
• Antagonization by beta-adrenergic blocking agents
• Avoidance of ergot alkaloids and tricyclic antidepressants
• Increased effect with diuretic agents
• Usage of vasodilators in patients with heart failure

Contraindications

• Hypersensitivity to dopamine or any of its ingredients
• Phaeochromocytoma
• Uncorrected tachyarrhythmias or ventricular fibrillation
• Simultaneous administration with dextrose solution without electrolytes

Side Effects

• Ectopic beats
• Nausea
• Vomiting
• Tachycardia
• Anginal pain
• Palpitations
• Dyspnoea
• Headache
• Hypotension
• Hypertension
• Vasoconstriction
• Aberrant ventricular conduction
• Bradycardia
• Piloerection
• Mydriasis
• Widened QRS complex
• Azotaemia
• Peripheral ischemic gangrene
• Fatal ventricular arrhythmias

Pregnancy & Lactation

• No evidence of teratogenic effects from dopamine hydrochloride in animal studies
• Usage in pregnant women based on expected benefits vs. potential risks
• Unknown excretion in breast milk and effect on the infant

Precautions & Warnings

• Avoidance in the presence of uncorrected tachyarrhythmia or ventricular fibrillation
• Metabolism by monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT)
• Dosing adjustment for patients with prior monoamine oxidase inhibitors (MAOI) treatment
• Risk of hypokalemia with excessive administration of potassium-free solutions
• Correction of hypovolaemia prior to treatment
• Closely monitoring in patients with impaired renal and hepatic function

Overdose Effects

• Excessive blood pressure elevation
• Temporary discontinuation or reduction in the rate of administration

Therapeutic Class

• Inotropic-sympathomimetics

Reconstitution

• Dilution before administration to patients
• Stable for a minimum of 24 hours after dilution
• Avoidance of addition to alkaline intravenous solutions and amphotericin B solution

Storage Conditions

• Storage below 25°C
• Protection from light

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