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