Indications for: LEVOPHED
To raise blood pressure in adults with severe, acute hypotension.
Correct hypovolemia before administration. Give by IV infusion after dilution into a large vein. Initially 0.25–0.375mL (or 8–12mcg of base) per minute; adjust flow rate to establish and maintain a low to normal BP (usually 80–100 mmHg systolic) sufficient to maintain the circulation of vital organs. Usual maintenance: 0.0625–0.125mL (or 2–4mcg of base) per minute. Withdraw gradually.
Risk of tissue ischemia. Avoid in those with mesenteric or peripheral vascular thrombosis. Occlusive or thrombotic vascular disease. Prolonged or high dose infusions. Avoid abrupt cessation. Withdraw gradually by reducing infusion rate. Risk of cardiac arrhythmias esp during hypoxia or hypercarbia. Perform continuous cardiac monitoring in those with arrhythmias. Avoid extravasation. Asthma. Sulfite sensitivity. Elderly: avoid infusion into leg veins. Pregnancy. Nursing mothers.
Risk of ventricular tachycardia or fibrillation with halothaned anesthetics (eg, cyclopropane, desflurane, enflurane, isoflurane, sevoflurane); monitor cardiac rhythm. Concomitant MAOIs (eg, linezolid) or tricyclic antidepressants (eg, amitriptyline, nortriptyline, protriptyline, clomipramine, desipramine, imipramine) can cause severe, prolonged hypertension; if unavoidable, monitor BP. May decrease insulin sensitivity and raise blood glucose with antidiabetic drugs; monitor and consider dose adjustment of antidiabetics.
Ischemic injury, bradycardia, anxiety, transient headache, respiratory difficulty, extravasation necrosis at inj site; tissue ischemia.
The mean half-life of norepinephrine is approximately 2.4 min. The average metabolic clearance is 3.1 L/min.
Noradrenaline metabolites are excreted in urine primarily as sulphate conjugates and, to a lesser extent, as glucuronide conjugates. Only small quantities of norepinephrine are excreted unchanged.
Single-dose vials (4mL) or ampules (4mL)—10