Levophed (Norepinephrine)

Mix 2mg in 250 ml D5W ONLY

Dose: 2-12 mcg per minute
Titrate to keep SBP 90-120

Action: Decreased blood flow to all organs except heart and brain.
(catecholamine- potent
alpha (arterial and
venous vasoconstriction)
with minimal beta
(increase contractility)

MIX 8mg/250cc D5W or
NSS (32mcg/ml)

Refractory SHOCK

Hemodynamically significant
hypotension refractory to other
sympathomimetics (septic and
neurogenic shock)

- Start with 0.5-1.0 mcg/min and
titrate to effect
* Increase BP by increasing SVR and thereby diminishing cardiac output (increases myocardia oxygen demand, causes myocardial ischemia)
* Needs A-line for monitoring BP
* Also monitor CO, PCWP, PA pressures

* Contraindicated in hypovolemia

Extravasation leads to necrosis- phentolamine infiltration minimizes sloughing

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