Paramedic Program (PDF)

Box 417 Lac La Biche, AB T0A 2C0 Paramedic Program Generic Name: norepinephrine Trade Name: Levophed Classification: adrenergic agonist (sympathomimetic), vasopressor Supplied: 4mg/4mL Actions (Pharmacodynamics):  Vasopressor: direct stimulation of alpha-adrenergic receptors, constricting both ca...

Box 417 Lac La Biche, AB T0A 2C0 Paramedic Program Generic Name: norepinephrine Trade Name: Levophed Classification: adrenergic agonist (sympathomimetic), vasopressor Supplied: 4mg/4mL Actions (Pharmacodynamics):  Vasopressor: direct stimulation of alpha-adrenergic receptors, constricting both capacitance and resistance blood vessels. This result in increased total peripheral vascular resistance, increased systolic and diastolic blood pressure, and decreased blood flow to vital organs, skin, skeletal muscle and renal blood flow.  Produces a positive inotropic response of the heart (beta1 receptors). Indications:  Hypotension MAP less than 65  Septic, Cardiogenic and Neurogenic shock  Treatment of shock after appropriate fluid resuscitation  Beta & Calcium Channel Blocker OD, Cholinesterase inhibitor poisoning, Cyclic Antidepressant OD, Digoxin OD, Ethanol poisoning, Head injury with MAP <70mmHg, Non-cyclic Antidepressant OD, Salicylate OD, Sedative OD  Vasopressor infusions may be administered after ROSC to support cardiac output, especially blood flow to the heart and brain. Dosage Adult 0.1 – 1.0 mcg/kg/min. IV infusion (*start at low dose and titrate to desired blood pressure) Pediatric 0.05-1.0 mcg/kg/min IV infusion (*start at low dose and titrate to desired blood pressure) Mix 4 mg in 250 mL D5W or NS (16 mcg/mL) Contraindications:  Mesenteric or peripheral vascular thrombosis  Hypotension related to hypovolemia without appropriate fluid replacement Precautions:  Do not mix with alkaline solutions as it can be deactivated (e.g. sodium bicarbonate).  If given with Beta blockers a markedly elevated BP can occur  Extravasation causes tissue necrosis; check frequently for signs of extravasation, stop infusion if this occurs.  Use with caution if patient is taking MAO Inhibitors or TCA; may precipitate hypertension Note:  Bradycardia arrythmias may occur  Administer into a large vein.  Infusion should be D/C gradually to ensure adequate tissue perfusion and ensure hypotension does not reoccur. References: 1 (165), (4 (947-949), 5 (329, 332) 6 (144), 8 (21-22), 10 (156), 11 (274) Revised: May 2023 © Portage College Paramedic Program Page 1 of 1