Norepinephrine bitartrate (Levophed®)

Adult Dose:

Standing order for post cardiac arrest management of systolic blood pressures less than 90 mmHg

• 8-12 mcg/minute
  
  • 4mg norepinephrine in 250 ml NS (16 mcg/ml)
    
  • 8mg norepinephrine in 500 ml NS (16 mcg/ml)
    

BIOTEL AUTHORIZATION required for patients experiencing cardiogenic shock

• 8-12 mcg/minute
  
  • 4mg norepinephrine in 250 ml NS (16 mcg/ml)
    
  • 8mg norepinephrine in 500 ml NS (16 mcg/ml)

• Potent peripheral vasoconstrictor
  
• Increases myocardial contractility

• Cardiogenic shock
  
• Post cardiac arrest management of hypotension

• Start IV’s in the antecubital fossa to lower risk of infiltration
  
• While administering continually check IV site for patency and signs/symptoms of infiltration
  
• Continually monitor blood pressure
  
• Do not mix with sodium bicarbonate; flush tubing well between drugs

• Tissue necrosis with infiltration
  
• Hypertension
  
• Headache
  
• Dysrhythmia
  
• Tachycardia
  
• Reflex bradycardia
  
• Chest pain