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GENERIC NAME Norepinephrine
BRAND NAME Levophed, Levarterenol
CLASS Sympathomimetic
MECHANISM OF ACTION Potent alpha-agonist resulting in intense vasoconstriction; Positive chronotropic and increased Inotropic effect (from 10% beta effects), with increased cardiac output.
INDICATIONS Cardiogenic shock, significant Hypotensive states (< 70 mm hg).
CONTRAINDICATIONS Hypotensive patients with hypovolemia, pregnancy (relative contraindication).
ADVERSE REACTIONS (10) Headache, arrhythmias, tachycardia, reflex Bradycardia; angina pectoris, hypertension; decreased blood flow to GI tract, kidneys, skeletal muscle, and skin.
NOTES ON ADMINISTRATION Pregnancy safety: Not established. May cause fetal anoxia when used in pregnancy. Must be infused through large stable vein to avoid tissue necrosis. Often used with low dose dopamine to spare renal and mesenteric blood flow.
INCOMPATABILITIES/DRUG INTERACTIONS Can be deactivated by alkaline solutions. Sympathomimetics and phosphodiesterase inhibitors may exacerbate arrhythmias. Bretylium may potentiate the effects of catecholamines.
DOSE/ROUTE, ADULT Dilute 8mg in 500ml of D5W. In fuse by IV piggyback at 0.5-1.0 mcg/min, titrated to improve blood pressure( up to 30mcg/min).
Dose/Route, PEDIATRIC 0.1-1.0 mcg/min IV infusion titrated to patients response.
ONSET OF ACTION 1-3 minutes
DURATION OF ACTION 5-10 minutes and lasts only 1 minutes after infusion discontinued.
Created by: klindley