An adequate patient history should be taken. Certain diseases or the concurrent use of some drugs accentuate the undesirable side effects of adrenaline or nor-adrenaline.
Their use is absolutely contra-indicated in the following conditions:
- Sensitivity to catecholamines.
- Thyrotoxicosis - Their use is also contra-indicated where the patient is receiving the following drugs:
- Sympathomimetic agents
- Tricyclic antidepressant drugs, MAOI inhibitors.
- Certain general anaesthetic agents (halothane, chloroform, trichlorethylene).
In these conditions felypressin (octapressin) is a safe alternative vasoconstrictor to adrenaline and nor-adrenaline, and may be used in circumstances where adverse reaction to these drugs is anticipated. Felypressin is the vasoconstrictor of choice should one be required in patients with cardiovascular disease and hypertension.
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