Norepinephrine (Levophed)

Question 1

Class / Action

Answer 1

Alpha & Beta Adrenergic Stimulator and Potent Vasoconstrictor & Inotrope / Acts predominately on peripheral alpha adrenergic receptors to produce constriction of resistance & capacitance vessels, increasing BP & coronary artery blood flow; Low Doses cause a cardiac stimulation effect which increases systolic, diastolic, & pulse pressures; Larger doses cause a vasoconstrictor effect.

Question 2

Onset / Duration of Action

Answer 2

ONSET: Immediate.
DURATION: 1-2min after infusion ends.

Question 3

Indications

Answer 3

1. Cardiogenic shock
2. Acute symptomatic hypotension secondary to non-hypovolemic states
3. Sepsis or septic shock

Question 4

Contraindications

Answer 4

1. True HypOvolemia
2. Mesenteric Thrombosis
3. MAOI Therapy

Question 5

Precautions

Answer 5

1. Preexisting HypErtension
2. Preexisting HypOtension
3. Peripheral Vascular Disease
4. Asthma
5. Pregnancy
6. Avoid extraversion of norepinephrine into surrounding tissue. If intravenous infusion infiltrates, it must be immediately removed. Notify the physician.

Question 6

Dosages / Administration

Answer 6

ADULT: 8-12mcg/min (0.1-0.5mcg/kg/min) IV infusion initial dose titrating to individual patient response.
ADULT: 2-4mcg/min maintenance dose. (Individual response is variable).
PEDIATRIC: 0.1mcg/kg/min to a MAX Rate of 2mcg/kg/min.
DO NOT ADMINISTER in Same IV tubing with Alkaline Solution

Question 7

Adverse Reactions

Answer 7

Arrhythmia, Pulmonary Edema, Bradycardia, HypErtension, Tachycardia, Anxiety.