Hospital Pharmacy - June 2019 - 189

Palagiri et al
Phenylephrine causes vasoconstriction by activating the
α1 receptors which causes smooth muscle cell activation and
contraction. Srivastava et al hypothesized that the chronotropic effect of the phenylephrine is due to its β1 action.13 It
is known that prolonged β-blocker use causes sympathetic
hyperinnervation of the myocardium.14 We hypothesize a
similar phenomenon may happen in the peripheral vessels,
potentiating the action of phenylephrine in a patient with
prolonged use of metoprolol.
We used the the Naranjo adverse drug reaction probability
scale to determine the causality of the reaction.15 The scale
contains 10 questions and scores for individual questions can
range from −1 to +2. With a total score >9, the incident is considered be a definite adverse drug reaction and with a score of
5 to 8, the incident is considered to be a probable adverse drug
reaction. Given the lack of another etiology and a Naranjo
Scale score of 6 in our patient (Table 1), intracavernosal phenylephrine is a probable cause of this patient's hypertensive
emergency and subsequent intracranial hemorrhage.15

Conclusion
A careful review for medication interaction with β-blockers
and patient's risk of hypertensive crisis should be performed
prior to intracavernosal administration of phenylephrine as it
can lead to hypertensive emergency and associated complications. Patients should be closely monitored with frequent vital
signs after administration of intracavernosal phenylephrine
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

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2. Eland IA, van der Lei J, Stricker BH, Sturkenboom MJ. Incidence of
priapism in the general population. Urology. 2001;57(5):970-972.

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Hospital Pharmacy - June 2019

Table of Contents for the Digital Edition of Hospital Pharmacy - June 2019

TOC/Verso
The Future CPOE Workflow: Augmenting Clinical Decision Support With Pharmacist Expertise
Contributing Factors to Perceptions of Residents’ Statistical Abilities
Mix-Ups Between Epidural Analgesia and IV Antibiotics in Labor and Delivery Units Continue to Cause Harm
Acute Hepatotoxicity After High-Dose Cytarabine for the Treatment of Relapsed Acute Myeloid Leukemia: A Case Report
Baloxavir Marboxil
Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy
The Culture of Carbapenem Overconsumption. : Where Does It Begin? Results of a Single-Center Survey
Clinical Pharmacist Impact on Intensive Care Unit Delirium: Intervention and Monitoring
A Case Report of Hypertensive Emergency and Intracranial Hemorrhage Due to Intracavernosal Phenylephrine
Stability of Meropenem After Reconstitution for Administration by Prolonged Infusion
Hypoglycemia Associated With Insulin Use During Treatment of Hyperkalemia Among Emergency Department Patients
Impact of Implementing Smart Infusion Pumps in an Intensive Care Unit in Mexico: A Pre-Post Cost Analysis Based on Intravenous Solutions Consumption
Hospital Pharmacy - June 2019 - Cover1
Hospital Pharmacy - June 2019 - Cover2
Hospital Pharmacy - June 2019 - 137
Hospital Pharmacy - June 2019 - 138
Hospital Pharmacy - June 2019 - 139
Hospital Pharmacy - June 2019 - 140
Hospital Pharmacy - June 2019 - 141
Hospital Pharmacy - June 2019 - 142
Hospital Pharmacy - June 2019 - 143
Hospital Pharmacy - June 2019 - 144
Hospital Pharmacy - June 2019 - 145
Hospital Pharmacy - June 2019 - 146
Hospital Pharmacy - June 2019 - TOC/Verso
Hospital Pharmacy - June 2019 - 148
Hospital Pharmacy - June 2019 - The Future CPOE Workflow: Augmenting Clinical Decision Support With Pharmacist Expertise
Hospital Pharmacy - June 2019 - 150
Hospital Pharmacy - June 2019 - 151
Hospital Pharmacy - June 2019 - 152
Hospital Pharmacy - June 2019 - Contributing Factors to Perceptions of Residents’ Statistical Abilities
Hospital Pharmacy - June 2019 - 154
Hospital Pharmacy - June 2019 - Mix-Ups Between Epidural Analgesia and IV Antibiotics in Labor and Delivery Units Continue to Cause Harm
Hospital Pharmacy - June 2019 - 156
Hospital Pharmacy - June 2019 - 157
Hospital Pharmacy - June 2019 - 158
Hospital Pharmacy - June 2019 - 159
Hospital Pharmacy - June 2019 - Acute Hepatotoxicity After High-Dose Cytarabine for the Treatment of Relapsed Acute Myeloid Leukemia: A Case Report
Hospital Pharmacy - June 2019 - 161
Hospital Pharmacy - June 2019 - 162
Hospital Pharmacy - June 2019 - 163
Hospital Pharmacy - June 2019 - 164
Hospital Pharmacy - June 2019 - Baloxavir Marboxil
Hospital Pharmacy - June 2019 - 166
Hospital Pharmacy - June 2019 - 167
Hospital Pharmacy - June 2019 - 168
Hospital Pharmacy - June 2019 - 169
Hospital Pharmacy - June 2019 - Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy
Hospital Pharmacy - June 2019 - 171
Hospital Pharmacy - June 2019 - 172
Hospital Pharmacy - June 2019 - 173
Hospital Pharmacy - June 2019 - 174
Hospital Pharmacy - June 2019 - The Culture of Carbapenem Overconsumption. : Where Does It Begin? Results of a Single-Center Survey
Hospital Pharmacy - June 2019 - 176
Hospital Pharmacy - June 2019 - 177
Hospital Pharmacy - June 2019 - 178
Hospital Pharmacy - June 2019 - 179
Hospital Pharmacy - June 2019 - Clinical Pharmacist Impact on Intensive Care Unit Delirium: Intervention and Monitoring
Hospital Pharmacy - June 2019 - 181
Hospital Pharmacy - June 2019 - 182
Hospital Pharmacy - June 2019 - 183
Hospital Pharmacy - June 2019 - 184
Hospital Pharmacy - June 2019 - 185
Hospital Pharmacy - June 2019 - A Case Report of Hypertensive Emergency and Intracranial Hemorrhage Due to Intracavernosal Phenylephrine
Hospital Pharmacy - June 2019 - 187
Hospital Pharmacy - June 2019 - 188
Hospital Pharmacy - June 2019 - 189
Hospital Pharmacy - June 2019 - Stability of Meropenem After Reconstitution for Administration by Prolonged Infusion
Hospital Pharmacy - June 2019 - 191
Hospital Pharmacy - June 2019 - 192
Hospital Pharmacy - June 2019 - 193
Hospital Pharmacy - June 2019 - 194
Hospital Pharmacy - June 2019 - 195
Hospital Pharmacy - June 2019 - 196
Hospital Pharmacy - June 2019 - Hypoglycemia Associated With Insulin Use During Treatment of Hyperkalemia Among Emergency Department Patients
Hospital Pharmacy - June 2019 - 198
Hospital Pharmacy - June 2019 - 199
Hospital Pharmacy - June 2019 - 200
Hospital Pharmacy - June 2019 - 201
Hospital Pharmacy - June 2019 - 202
Hospital Pharmacy - June 2019 - Impact of Implementing Smart Infusion Pumps in an Intensive Care Unit in Mexico: A Pre-Post Cost Analysis Based on Intravenous Solutions Consumption
Hospital Pharmacy - June 2019 - 204
Hospital Pharmacy - June 2019 - 205
Hospital Pharmacy - June 2019 - 206
Hospital Pharmacy - June 2019 - 207
Hospital Pharmacy - June 2019 - 208
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