Norepinephrine Flashcards

1
Q

Alternate Names

A

Noradrenaline, Levophed, leave-em-dead

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2
Q

Drug Class (Pharmacologic and Therapeutic)

A
  1. Pharmacologic Class - direct acting adrenergic agonist

2. Therapeutic Class - vasopressor, vasoconstrictor

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3
Q

Pharmacodynamics

A

Major action: stimulate peripheral alpha 1 adrenoreceptors -> leading to vasoconstriction (resistance arterioles, increases SVR) and venoconstriction (inc. preload) –> Increase CO, SVR, and MAP
Alternate Action: stimulates beta - 1 receptors in the heart, inc. HR and contractility
Overall Action: vasoconstriction and cardiac stimulation
Negatives: dec. blood flow to vulnerable tissues like skin, muscle, kidney.

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4
Q

Pharmacokinetics:

A

F ~ 100%; GIVEN IV ONLY. Metabolized by COMT and MAO mostly in LIVER; Metabolites excreted in URINE; Can cross the placenta but not the BBB

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5
Q

Half Life

A

1-2 minutes (titrated quickly IV)

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6
Q

Toxicity

A

excessive vasoconstriction in mesenteric vessels, peripheral arterioles causing ischemia, infarction, gangrene; reflex bradycardia

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7
Q

Interactions

A

Caution in patients taking MAOIs such as PHENELZINE (use lower dose); risk of excessive hypertension in patients taking propranolol ?

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8
Q

Special Considerations

A

Correct volume depletion with IV fluids BEFORE giving NE infusion; select infusion site carefully - extravasation is a major problem; monitor patient and BP continuously in ICU setting; use cautiously in pediatric and geriatric patients

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9
Q

Indications and Dose / Route

A

For adults with acute hypotension and shock (related to low SVR); Infuse 2-12 mcg/min

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10
Q

Monitor

A

BP, HR, infusion site, evidence of extravasation

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