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)
effect
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