Ortho-Preferred

Norepinephrine/Levodopa


- See: 
- Inotropic Agents 
- Discussion:
- for hypotension refactory to high doses of dopamine ( >20 ug/kg/min); 
- is peripherally converted to dopamine
- Dosing: many patients require up to 40 ug/ml - titrate to blood pressure; 
- Peds: initially 0.1 ug/kg/min titrated to effect; 
- Method of Delivery: 
- infusion is prepared by diluting 4-8 mg of Norepi in 500ml of D5W (gives 8-16 ug/ml) and infused at an initial rate of 4-12 ug/min; 
- Precautions: 
- central intraarterial monitoring may be required with prolonged infusions to avoid confusion owing to peripheral vasocontriction;  
- monitor urine output; 
- infuse into large vein to avoid extravasation; 
- if extravasation of norepinephrine occurs, infiltration of subQ tissue w/ phentolamine 5-10 mg in 10-15 ml of NS may prevent tissue necrosis; - must correct blood volume depletion as much as possible prior to initiation of vasopressor therapy; dilute in D5W or D5NS; 
- interactions w/ MAOIs & tricyclics leading to severe, prolonged HTN 

 




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, December 20, 2011 11:38 am