Norepinephrine (Levophed)

Question 1

Norepinephrine (Levophed)class

Answer 1

sympathomimetic

Question 2

Norepinephrine (Levophed):route

Answer 2

IVPB

Question 3

Norepinephrine (Levophed)adult dose

Answer 3

dilute either 4 mg in 250 ml or 8 mg in 500 ml of NS or D5W (16 mcg/ml concentration)dose is 8-12 mcg/minmay need higher doses to achieve adequate perfusion in drug-induced hypotension, like tricyclics

Question 4

Norepinephrine (Levophed)pedi dose

Answer 4

not used in the prehospital setting

Question 5

Norepinephrine (Levophed)drug actions

Answer 5

alpha and beta 1 adrenergic agonistpotent vasoconstrictor that also acts on the myocardial contractilityit tends to constrict the renal and mesenteric blood vessels, which should be watched carefully during administrationnot commonly used in pre-hospital setting

Question 6

Norepinephrine (Levophed)indications

Answer 6

severe cardiogenic shockneurogenic shockinotropic supporthemodynamically significant hypotension (usually BP less than 70) refractory to use of other sympathomimetic aminescardiac arrest with return of spontaneous circulation (ROSC) and BP less than 90

Question 7

Norepinephrine (Levophed)precautions

Answer 7

may cause fetal anoxia when used during pregnancyinfuse through a large, stable veindo not administer in same IV line as alkaline solutionuse infusion pump if possible to ensure a precise flow rate

Question 8

Norepinephrine (Levophed)side effects

Answer 8

headachedysrhythmiastachycardiareflex bradycardiaangina pectorishypertensiontissue necrosis with infiltration

Question 9

Norepinephrine (Levophed)contraindications

Answer 9

hypovolemia

Question 10

Norepinephrine (Levophed)drug interactions

Answer 10

can be deactivated by alkaline solutionsbeta-adrenergic antagonists may blunt responsesome other drugs may potentiate the effects of catecholamines