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The same type of cardiac arrhythmias may result from the use of LEVOPHED in patients with profound hypoxia or hypercarbia. Walker SE, Law S, Garland J, et al, "Stability of norepinephrine solutions in normal saline and 5% dextrose in water", Can J Hosp Pharm, 2010; Volume 63:pp. Diluent: LEVOPHED should be diluted in 5 percent dextrose injection or 5 percent dextrose and sodium chloride injections. -The manufacturer product information should be consulted. Plöchl, W, D J Cook, T A Orszulak, and R C Daly. Initial: 8-12 mcg/min IV infusion; titrate to effect, 0.01-3.3 mcg/kg/min IV infusion (Hollenberg 2009), Should be titrated to age-appropriate blood pressure, Initial: 0.05-0.1 mcg/kg/min IV infusion; titrate to effect, 0.05-0.1 mcg/kg/min IV infusion; titrate to effect; not to exceed 2 mcg/kg/min, Dyspnea, with or without respiratory difficulty, Antidote for extravasation ischemia: To prevent sloughing and necrosis in areas where extravasation has taken place, infiltrate areas promptly with 10-15 mL of saline solution containing 5-10 mg of phentolamine mesylate for injection, Use syringe with fine hypodermic needle, with the solution being infiltrated liberally throughout the area, which is easily identified by its cold, hard, pallid appearance, Patients who are hypotensive from blood volume deficits except as an emergency measure to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed, Peripheral vascular thrombosis (except for lifesaving procedures), Concomitant use with some general anesthetics cyclopropane (not available in the US), halothane (not available in the US), If therapy is continuously administered to maintain blood pressure in absence of blood volume replacement, severe peripheral and visceral vasoconstriction, decreased renal perfusion and urine output, poor systemic blood flow despite “normal” blood pressure, tissue hypoxia, and lactate acidosis may occur, Use extreme caution with concurrent monoamine oxidase inhibitor (MAOI) use or antidepressants of the triptyline or imipramine types; severe, prolonged hypertension may result, Cyclopropane and halothane anesthetics increase cardiac autonomic irritability and seem to sensitize the myocardium to action of intravenously administered epinephrine or norepinephrine, Not for use in profound hypoxia or hypercarbia, Bitartrate injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people, Because of potency of drug and because of varying response to pressor substances, possibility always exists that dangerously high blood pressure may be produced with overdoses of this pressor agent; it is desirable, therefore, to record blood pressure every two min from time administration is started until desired blood pressure is obtained, then every five min if administration is to be continued; rate of flow must be watched constantly, and patient should never be left unattended while receiving therapy; headache may be a symptom of hypertension due to overdosage, When possible, infusions should be given into large vein, particularly an antecubital vein to reduce risk of necrosis of overlying skin from prolonged vasoconstriction; some authors have indicated that femoral vein is an acceptable route of administration; occlusive vascular diseases (for example, atherosclerosis, arteriosclerosis, diabetic endarteritis, Buerger’s disease) are more likely to occur in the lower than in the upper extremity; one should avoid the veins of the leg in elderly patients or in those suffering from such disorders; gangrene has been reported in a lower extremity when infusions were given in an ankle vein, Infusion site should be checked frequently for free flow; care should be taken to avoid extravasation of drug into tissues, as local necrosis might ensue due to vasoconstrictive action of drug; blanching along the course of the infused vein, sometimes without obvious extravasation, has been attributed to vasa vasorum constriction with increased permeability of vein wall, permitting some leakage, Lactation: Not known if excreted into breast milk; avoid use during breastfeeding. While I'm still an Advance I'm not getting that training but I like to harass medics so hopefully I'll know how to work them by then. ], Regitine, trademark, CIBA Pharmaceuticals Company.

Comments: Strong beta1- and alpha-adrenergic effects and moderate beta2 effects, which increase cardiac output and heart rate, decrease renal perfusion and PVR, and cause variable BP effects, Metabolized by MAO and catechol-O-methyl transferase (COMT) in the adrenergic neuron, Metabolites: Normetanephrine, vanillylmandelic acid (inactive), Not spec: Atropine, carbenicillin, cefazolin, diazepam, Additive: Calcium gluconate, cimetidine, dobutamine, heparin, KCl, verapamil, vitamins B/C, Y-site: Amiodarone, epinephrine, esmolol, fentanyl, furosemide, heparin, hydrocortisone, KCl, vitamins B/C, Solution: 4 mg in 1000 ml D5W (4 mcg/ml); 40 ml/hr (~3 mcg/min); dose may be titrated to patient response, Do not administer NaHCO3 through an IV line containing norepinephrine. Comments: PLEASE READ THE. Start. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Titrate to MAP>60 or as ordered Neo-Synephrine (Phenylephrine) 50mg/250cc 100mcg/min titrate 20mcg/min q 10 mins max 200mcg/min Titrate to MAP>60 or as ordered Diprivan (Propofol) 1g/100cc 5mcg/kg/min titrate 5-10mcg/kg/min max of 50 mcg/kg/min This drug is available at the lowest co-pay. First line for sepsis. commonly, these are "preferred" (on formulary) brand drugs. 253068-overview General: Use: As an adjunct in the treatment of cardiac arrest Reconstitution/preparation techniques:

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