Mechanism of action
- Benzylisoquinolone alkaloid
- Inhibition of cAMP and cGMP phosphodiesterases in smooth muscle → increased intracellular levels of cAMP and cGMP → vasodilation of arteries and arterioles
- Inhibit the release of calcium from the intracellular space by blocking calcium ion channels in the cell membrane.
Pharmacokinetic
- Short acting, with half–life of less than 1 hour.
Indications and case selection
- Pre-treatment for angioplasty.
- The resulting vasodilatation will assist with balloon catheter placement.
- Due to its short duration of action necessitating repeated administration,
- Other agents e.g., verapamil, are generally preferred.
Dosing
- ℞: 300mg of 3% papaverine (30mg/ml) at pH 3.3, is diluted in 100ml of normal saline to obtain a 0.3% concentration.
- It is administered intra-arterially through the microcatheter, which is positioned just proximal to the affected vascular segment at a rate of 3ml/minute.
Caution
- ❌ Do not mix Papaverine with contrast agents or heparin, which may result in precipitation of crystals.
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