Pharmacology – Norepinephrine / Levophed

Class
Sympathetic agonist – stimulate the sympathetic nervous system
Catecholomine

Description
Naturally occurring catecholamine

Acts on both a and b adrenergic receptors

Action on a receptors is more profound

Mechanism of Action
Potent peripheral vasoconstrictor
Increases blood pressure in cardiogenic shock and other hypotensive emergencies
Tends to constrict the renal and mesenteric blood vessels
Reserved for emergencies in which other vasopressors may not be effective.

Pharmacokinetics
Onset: Immediate
Peak Effects: < 1 minute Duration: 1-2 minutes Half life: 3 minutes

Indications
Hypotension / systolic BP 70 mmHg refractory ot other sympathomimetics

Hypotension not related to hypervolemia

Neurogenic shock

Contraindications
Hypotension secondary to hypovolemia

Precautions
Measure the blood pressure every 5-10 minutes to prevent dangerously high blood pressure

Fluid replacement should be initiated prior to administration

May cause local tissue necrosis if it extravagates

Will increase myocardial oxygen demand

Use with caution in persons with cardiac ischemia

Side Effects
Anxiety
Tremors
Headache
Dizziness
Reflex bradycardia
Increased myocardial oxygen demand

Interactions
Can be deactivated by alkaline solutions such as sodium bicarbonate

Concomitant administration with b blockers can result in markedly elevated BP

Dosage
0.5-1.0 mcg / minute / max of 30.0 mcg / minute

Higher doses may be required to maintain adequate blood pressure

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Epinephrine Classification Sympathomimetic, sympathetic agonist, catecholamine, antidysrhythmic, vasopressor, inotropic agent, bronchodilator Epinephrine Mechanism of Action Acts directly on Alpha & Beta receptors of the Sympathetic Nervous system. Beta effects are more profound than Alpha effects. Effects include: -Increased HR (chronotropy) …

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