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NORepinephrine
NORepinephrine
Classification
Alpha- and beta-agonist
Indications
CCP: Symptomatic bradycardia
CCP: Shock with hypotension refractory to fluid resuscitation
CCP: Cardiogenic shock with refractory hypotension
Contraindications
- Mesenteric or peripheral vascular thrombosis
- Pregnancy
- Profound hypoxia
- Hypovolemia
Adult dosages
CCP: All indications
- 0.1 mcg/kg/minute IV/IO
- Titrate upwards to a maximum of 1 mcg/kg/minute.
Pediatric Considerations And Dosing
Follow weight-based dosing.
CCP: All indications
- 0.1 mcg/kg/minute IV/IO
- Titrate upwards to a maximum of 1 mcg/kg/minute.
Mechanism Of Action
Stimulates alpha and beta-1 adrenergic receptors causing increased contractility, heart rate, and vasoconstriction.
Pharmocokinetics
Following intravenous administration:
- Onset: very rapid
- Duration: 1-2 minutes
- Half-life: 2-3 minutes
Adverse Effects
Cardiovascular: Bradycardia, cardiac arrhythmia, cardiomyopathy (stress), peripheral vascular insufficiency
Central nervous system: Anxiety, transient headache
Respiratory: Dyspnea
Source: Norepinephrine. In: Lexicomp Online, UpToDate, Waltham, MA. (Accessed November 20, 2020.)
Warning And Precautions
- Correct hypovolemia prior to administering NORepinephrine.
- Hypoxia or hypercarbia may produce ventricular tachycardia or ventricular fibrillation.
- Avoid extravasation of NORepinephrine. Administer into a large vein whenever possible. Monitor catheter and line patency before and during administration.
Classification
Alpha- and beta-agonist
Indications
CCP: Symptomatic bradycardia
CCP: Shock with hypotension refractory to fluid resuscitation
CCP: Cardiogenic shock with refractory hypotension
Contraindications
- Mesenteric or peripheral vascular thrombosis
- Pregnancy
- Profound hypoxia
- Hypovolemia
Adult dosages
CCP: All indications
- 0.1 mcg/kg/minute IV/IO
- Titrate upwards to a maximum of 1 mcg/kg/minute.
Pediatric Considerations And Dosing
Follow weight-based dosing.
CCP: All indications
- 0.1 mcg/kg/minute IV/IO
- Titrate upwards to a maximum of 1 mcg/kg/minute.
Mechanism Of Action
Stimulates alpha and beta-1 adrenergic receptors causing increased contractility, heart rate, and vasoconstriction.
Pharmocokinetics
Following intravenous administration:
- Onset: very rapid
- Duration: 1-2 minutes
- Half-life: 2-3 minutes
Adverse Effects
Cardiovascular: Bradycardia, cardiac arrhythmia, cardiomyopathy (stress), peripheral vascular insufficiency
Central nervous system: Anxiety, transient headache
Respiratory: Dyspnea
Source: Norepinephrine. In: Lexicomp Online, UpToDate, Waltham, MA. (Accessed November 20, 2020.)
Warning And Precautions
- Correct hypovolemia prior to administering NORepinephrine.
- Hypoxia or hypercarbia may produce ventricular tachycardia or ventricular fibrillation.
- Avoid extravasation of NORepinephrine. Administer into a large vein whenever possible. Monitor catheter and line patency before and during administration.