Norepinephrine (Levophed) Flashcards
Norepinephrine (Levophed)
Class
Sympathomimetic
Norepinephrine (Levophed)
Mechanism of Action
Potent alpha-agonist resulting in intense vasoconstriction; positive chronotropic and inotropic effect with increased cardiac output.
Norepinephrine (Levophed)
Indications
Cardiogenic shock, significant hypotensive states (< 70 mmHg).
Norepinephrine (Levophed)
Contraindications
Hypotensive patients with hypovolemia, pregnancy (relative
contraindication).
Norepinephrine (Levophed)
Adverse Reactions
Headache, arrhythmias, tachycardia, reflex bradycardia, angina pectoris, hypertension; decreased blood flow to the GI tract, kidneys, skeletal muscle, and skin.
Norepinephrine (Levophed)
Drug Interactions
Can be deactivated by alkaline solutions. Sympathomimetics and phosphodiesterase, inhibitors may exacerbate arrhythmias. Bretylium may potentiate the effects of catecholamines.
Norepinephrine (Levophed)
Adult Dosage
Dilute 8 mg in 500 mL of D5W or 4 mg in 250 mL of D5W; infuse by IV piggyback at 0.5 – 30.0 mcg/min IV infusion, titrated to patient response.
Norepinephrine (Levophed)
Pediatric Dosage
0.1 – 1.0 mcg/min infusion; titrated to patient response.
Norepinephrine (Levophed)
Onset
1-3 Minutes
Norepinephrine (Levophed)
Peak Effect
Variable
Norepinephrine (Levophed)
Duration
5-10 Minutes
Norepinephrine (Levophed)
Special Considerations
Must be infused through a large stable vein to prevent necrosis. Often used in conjunction with low-dose Dopamine to spare renal and mesenteric blood flow.