Norepinephrine (Levophed)

Question 1

Classification

Answer 1

Adrenergic agonist, inotropic, vasopressor

Question 2

Action

Answer 2

Norepinephrine is an alpha1, alpha2, and beta1 agonist. Alpha mediated peripheral vasoconstriction is the predominant clinical result of administration, resulting in increasing blood pressure and coronary blood flow. Beta andrenergic action produces inotropic stimulation of the heart and dilates the coronary arteries

Question 3

Indications

Answer 3

Carcinogenic shock, septic shock, severe hypotension

Question 4

Adverse effects

Answer 4

Dizziness, anxiety, cardiac arrhythmias, dyspnea, exacerbation of asthma

Question 5

Contraindications

Answer 5

Patients taking MAOIs, known sensitivity. Use with caution in hypovolemia

Question 6

Adult dosage

Answer 6

Add 4 mg to 250 mL of D5W or D5NS but not normal saline alone. 0.5 to 1 mcg/min as IV, IO, titrate do to maintain systolic blood pressure >80 mm Hg. Refractory shock may require doses as high as 30 mcg/min

Question 7

Peds dosage

Answer 7

0.05 to 2 mcg/kg/min IV, IO infusion, to a maximum dose of 2 mcg/kg/min

Question 8

Special considerations

Answer 8

Do not administer in same IV line as alkaline solutions; half-life 1 min; pregnancy class c