angiotensin ii

section name header

Indications ⬇

REMS

Increases blood pressure in septic or other distributive shock.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

None.

Use Cautiously in:

OB: Use only if potential maternal benefit outweighs potential fetal risk
Lactation: Safety not established;
Pedi: Safety and effectiveness in children not established.

Adv. Reactions/Side Effects ⬆ ⬇

CV: thromboembolic events, peripheral ischemia, tachycardia

Endo: hyperglycemia

Hemat: thrombocytopenia

Neuro: delirium

Misc: fungal infection

Interactions ⬆ ⬇

Drug-drug:

Concurrent use with ACE inhibitors may ↑ vasopressor effects.
Concurrent use with angiotensin receptor blockers may ↓ vasopressor effects.

Availability ⬆ ⬇

Solution for IV infusion (must be diluted): 2.5 mg/mL

Route/Dosage ⬆ ⬇

IV (Adults ): 20 ng/kg/min continuous infusion; may be titrated every 5 min of up to 15 ng/kg/min to achieve or maintain target mean arterial pressure. Do not exceed dose of 80 ng/kg/min during first 3 hr. During maintenance therapy, do not exceed dose of 40 ng/kg/min. Once shock has adequately improved, titrate down by 15 ng/kg/min every 5–15 min based on mean arterial pressure.

US Brand Names ⬆ ⬇

Giapreza

Action ⬆ ⬇

Causes vasoconstriction and release of aldosterone, which lead to an increase in blood pressure.

Therapeutic effects:

Increase in mean arterial pressure.

Classifications ⬆ ⬇

Therapeutic Classification: vasopressors

Pharmacologic Classification: vasopressors

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/Excretion: Metabolized by aminopeptidase A and angiotensin converting enzyme 2 to angiotensin-(2-8) [angiotensin III] and angiotensin-(1-7), respectively in plasma, erythrocytes and many major organs.

Half-Life: <1 min.

Time/Action Profile ⬆ ⬇

(increase in mean arterial pressure)

ROUTE	ONSET	PEAK	DURATION
IV	minutes	5 min	minutes

Patient/Family Teaching ⬆ ⬇

Educate patient on purpose of angiotensin II.
Advise female patient to notify health care profession if pregnant.

Pronunciation ⬆

an-jee-oh-TEN-sin too