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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › CARDIAC STIMULANTS EXCL. CARDIAC GLYCOSIDES › Adrenergic and dopaminergic agents
norepinephrine
C01CA03
Forms & Strengths
- Injection: 1mg/mL
- Concentrate for infusion: 4mg/mL, 8mg/mL
- Solution for infusion: 0.008mg/mL to 0.16mg/mL
Adult Dosing
- Initial dose: 0.05-0.1mcg/kg/min
- Titrate to desired effect, typically 0.05-2mcg/kg/min
- Maximum dose: 2.2mcg/kg/min or as clinically indicated
Pediatric Dosing
- Neonates and infants: 0.01-0.1mcg/kg/min
- Children: 0.05-2mcg/kg/min
- Titrate to desired effect
Indications
- Sepsis, shock, and severe hypotension
- Cardiac arrest
- Vasodilatory shock
- To maintain blood pressure in cases of anaphylaxis
Mechanism of Action
- Stimulates alpha-1 adrenergic receptors, causing vasoconstriction
- Increases blood pressure and cardiac output
- Stimulates beta-1 receptors at higher doses, increasing heart rate
Contraindications
- Hypersensitivity to norepinephrine or sulfites
- Mesenteric or peripheral vascular thrombosis
- Pheochromocytoma or other conditions with high levels of endogenous catecholamines
Adverse Reactions
- Hypertension
- Tachycardia
- Bradyarrhythmias
- Extravasation leading to tissue necrosis
- Myocardial infarction
Drug Interactions
- Alpha-adrenergic blockers
- Beta blockers
- Ergot derivatives
- Oxytocic agents
- Tricyclic antidepressants
Curated Content: Needs Vetting Before Put to Clinical Use