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NOREPINEPHRINE BITARTRATE (Levophed)

Name/Class: NOREPINEPHRINE BITARTRATE (Levophed) Sympathomimetic, vasopressor

Description: Potent alpha-agonist resulting in intense perpipheral vasoconstriction, positive chronotropic and increased inotropic effect (from 10% beta effect) with increased cardiac output. Alpha-adrenergic activity resulting in peripheral vasoconstriction and beta-adrenergic activity leading to inotropic stimulation of the heart and coronary artery vasodilation.

Indications: Cardiogenic shock, unresponsive to fluid resuscitation, significant hypotensive (<70 mm Hg) sates

Contraindications: Hypotensive patients with hypovolemia, pregnancy (relative)

Precautions/Side Effects: Bradycardia, hypertension, dysrhythmias, chest pain, peripheral cyanosis, tissue necrosis from extravasation.

Dosage/Route: Dilute 8 mg in 500 mL of D5W or 4 mg in 250 mL of D5W (16 ug/mL). Infuse by IV piggy-back at 0.1-0.5 ug/kg/min titrated to response (average dose for 70 kg patient 7-35 ug/min).

Pedi: Begin at 0.1-2 ug/kg/min IV infusion, adjust rate to achieve desired change in blood pressure and systemic perfusion. Titrated to patient response.

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