Levarterenol = Norepinephrine (Levophed)

Category:

  • Respiratory

Description:

  • Vasopressor

Indications:

  • Acute hypotensive states

  • Adjunct in treatment of cardiac arrest and profound hypotension

Contraindications:

  • Hypovolemia (except as an emergency measure until volume replacement can be completed

  • Mesenteric or peripheral vascular thrombosis, cyclopropane and halothane anesthesia

Precautions:

  • Pregnancy category D

  • Atherosclerosis, anteriosclerosis, diabetic endarteritis, Buerger’s disease

  • Elderly, extravasation, sulfite sensitivity

Adverse Reactions (Side Effects):

  • CNS: anxiety, headache

  • CV: bradycardia, cardiac dysrhythmias, chest pain, hypertension, palpitations, tachycardia

  • GI: nausea, vomiting

  • SKIN: diaphoresis, gangrene, necrosis and sloughing following extravasation, pallor

  • MISC: organ ischemia, photophobia, respiratory distress

Dosage:

Administered intravenously

  • Adult:   
    • IV INF 8-12 mcg/min; initiate at 4mcg/min and titrate to desired response
  • Child:   

    • IV INF 0.05-0.1 mcg/kg/min initially, titrate to desired effect

Special Consideration:

  • Antidote for extravasation ischemia; infiltrate with 10-15ml of saline containing 5-10mg of phentolamine

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