Bolus Injection of Cimetidine and Hypotension in Patients in the Intensive Care Unit

The diagnosis and management of anaphylaxis: An updated practice parameter

“…Cimetidine, 4 mg/kg in adults, should be administered slowly because rapid intravenous administration might produce hypotension. 58 Cimetidine should not be administered to children with anaphylaxis because no dosages have been established.…”

“…B A few drugs might elicit IgEmediated reactions without first combining with a carrier protein. 58. Penicillin is the most common cause of drug-induced anaphylaxis.…”

Haemodynamic effects of H2‐receptor antagonists

“…Three other studies [81-831 reported a fall in blood pressure and a possibly reactive rise in heart rate following intravenous administration of cimetidine while ranitidine did not produce these changes. As an example, a fall in blood pressure without occurrence of reflex tachycardia [82] is shown in Fig. 2.…”

“…Several of the investigations were performed on patients in intensive care units [75,79,8 1-85] being concurrently treated with other drugs affecting the cardiovascular parameters under consideration. For example, catecholamines or other vasoactive substances were administered to patients in some of these studies [79,81,82,85]. In other investigations, only partial information about concomitant treatment in these critically ill patients was presented [75,83].…”

Clinical Aspects of Cardiovascular Effects of H2‐Receptor Antagonists

“…A decrease in blood pressure after intravenous cimetidine administration has been noted most frequently.82. [85][86][87][88][89] In some studies, the decrease in blood pressure induced by cimetidine was accompanied by an increase in heart rate. 8S.88 For the newer Hj-receptor antagonist nizatidine, a marked negative chronotropic effect could be demonstrated.l'P"?'…”