What happens if I overdose Krunamina?
Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
In the event of an overdose, medical care providers in an intensive care setting are able to quickly treat any symptoms that may occur.
Overdose of Krunamina in details
Symptoms: Bradycardia, hypotension, oversedation, somnolence, cardiac arrest. Management: Treat sinus arrest w/ atropine and glycopyrrolate. Resuscitation was needed in isolated cases of severe overdose resulting in cardiac arrest.
What should I avoid while taking Krunamina?
Follow the doctor's instructions about any restrictions on food, beverages, or activity.
What should I discuss with my healthcare provider before taking Krunamina?
You should not be treated with Krunamina if you are allergic to it.
To make sure Krunamina is safe to give, tell the doctor if the patient has:
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liver disease;
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diabetes;
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high blood pressure;
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a serious heart condition such as severe heart block, or "AV block";
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a heart rhythm disorder; or
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low blood pressure, or if the patient may be dehydrated.
It is not known whether this medicine will harm an unborn baby. Tell the doctor if the patient is pregnant or plan to become pregnant.
The patient should not breast-feed within 10 hours after receiving Krunamina. If a breast pump is used during this time, any milk collected should be thrown out and not fed to a baby.
Krunamina precautions
Concerns related to adverse effects:
• Cardiovascular effects: Episodes of bradycardia, hypotension, and sinus arrest have been associated with rapid IV administration (eg, bolus administration) or when given to patients with high vagal tone. When used for ICU sedation, use of a loading dose is optional; for the maintenance infusion, titration no more frequently than every 30 minutes may reduce the incidence of hypotension (Gerlach 2009). If medical intervention is required, treatment may include stopping or decreasing the infusion, increasing the rate of IV fluid administration, use of pressor agents, and elevation of the lower extremities. At low concentrations, mean arterial pressure (MAP) may be reduced without changes in other hemodynamic parameters (eg, pulmonary artery occlusion pressure [PAOP]); however, at higher concentrations (>1.9 ng/mL), MAP, CVP, PAOP, PVR, and SVR increase (Ebert 2000).
• Transient hypertension: Has been primarily observed during loading dose administration and is associated with the initial peripheral vasoconstrictive effects of Krunamina. Treatment is generally unnecessary; however, reduction of infusion rate may be required.
Disease-related concerns:
• Cardiovascular disease: Use with caution in patients with heart block, bradycardia, severe ventricular dysfunction, hypovolemia, or chronic hypertension. In a scientific statement from the American Heart Association, Krunamina has been determined to be an agent that may exacerbate underlying myocardial dysfunction (magnitude: moderate) (AHA [Page 2016]).
• Diabetes: Use with caution in patients with diabetes mellitus; cardiovascular adverse events (eg, bradycardia, hypotension) may be more pronounced.
• Hepatic impairment: Use with caution in patients with hepatic impairment; dosage reductions recommended.
Concurrent drug therapy issues:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
Special populations:
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Elderly: Use with caution in the elderly; cardiovascular events (eg, bradycardia, hypotension) may be more pronounced. Dose reduction may be necessary.
Other warnings/precautions:
• Arousability: Patients may be arousable and alert when stimulated. This alone should not be considered as lack of efficacy in the absence of other clinical signs/symptoms.
• Experienced personnel: Should be administered only by persons skilled in management of patients in intensive care setting or operating room. Patients should be continuously monitored.
• Tolerance and tachyphylaxis: Use of infusions >24 hours has been associated with tolerance and tachyphylaxis and dose-related increase in adverse reactions.
• Withdrawal: When withdrawn abruptly in patients who have received >24 hours of therapy, withdrawal symptoms may result (eg, hypertension, tachycardia, nervousness, nausea, vomiting, agitation, headaches). Use for >24 hours is not recommended by the manufacturer.
What happens if I miss a dose of Krunamina?
Because you will receive Krunamina in a clinical setting, you are not likely to miss a dose.
References
- DrugBank. "DEXMEDETOMIDINE". http://www.drugbank.ca/drugs/DB00633 (accessed September 17, 2018).
- MeSH. "Analgesics, Non-Narcotic". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
