We need you! Join our contributor community and become a WikEM editor through our open and transparent promotion process.
Norepinephrine
From WikEM
Contents
General
- Type: Vasopressors
- Dosage Forms:
- Common Trade Names: Levophed
Adult Dosing
Dosing
- Usual Adult Dose for Hypotension. Initial dose: 2 to 4 mcg/min with titration to 25 mcg/min
Based on Glomerular Filtration Rate [GFR (ml/min)]
- <10: 0.2mcg/kg/min
- 10-40: 0.3mcg/kg/min
- >40-50: 0.4mcg/kg/min
- For CVVHD: dose at 0.4mcg/kg/min
- For HD: dose 0.2mcg/kg/min
Rate of Titration
- Q2-5 min
Pediatric Dosing
Special Populations
- Pregnancy Rating:
- Lactation:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
- If extravasation occurs use phentolamine 0.1 to 0.2mg/kg (maximum dose 10mg) subcutaneous in affected site[1][2]
- Consult plastic/general surgery service to follow the patient and eval for need for intervention
Serious
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
Primary Receptor
- α1 >> β1
Relative Effects
- ↑↑↑SVR
- ↑HR
- ↑SV
Notes
More potent vasoconstrictor than dopamine and phenylephrine.
Indication
- Septic shock (1st line)
- Cardiogenic shock:
- If marked hypotension (SBP <70)
- If used with dobutamine
See Also
External Links
References
- ↑ ZUCKER G. et al. Treatment of shock and prevention of ischemic necrosis with levarterenol-phentolamine mixtures. Circulation. 1960 Nov;22:935-7.
- ↑ PELNER L. et al. The problem of levarterenol (levophed) extravasation an experimental study.. Am J Med Sci. 1958 Dec;236(6):755-66
