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Levophed Dosing

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Last Updated: 25 October 2020

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General | Latest Info

Norepinephrine Bitartrate INJECTION is a concentrate, potent drug which must be DILUTE in Dextrose containing solutions prior to INFUSION. Infusion of LEVOPHED should be give into large vein. Blood volume depletion should always be correct as fully as possible BEFORE any vasopressor is administer. When, as an emergency measure, intraaortic pressures must be maintained to prevent cerebral or coronary artery ischemia, LEVOPHED can be administered BEFORE and concurrently with blood volume replacement. Average Dosage: Add 4 mL ampul of LEVOPHED To 1 000 mL of 5 percent Dextrose containing solution. Each mL of this dilution contains 4 mcg of base of LEVOPHED. Give this solution by INTRAVENOUS INFUSION. Insert plastic INTRAVENOUS catheter through suitable bore needle well advanced centrally into the vein and securely fixed with adhesive tape, avoiding, if possible, catheter tie - in technique as this promotes stasis. A drip chamber or other suitable metering device is essential to permit accurate estimation of the rate of flow in drops per minute. After observing response to an initial dose of 2 mL to 3 mL per minute, adjust the rate of flow to establish and maintain low normal blood pressure sufficient to maintain circulation to vital organs. In previously hypertensive patients, it is recommended that blood pressure should be raised no higher than 40 mm Hg below preexisting systolic pressure. The average maintenance dose ranges from 0. 5 mL To 1 mL per minute. High Dosage: Great individual variation occurs in the dose required to attain and maintain adequate Blood Pressure. In all cases, dosage of LEVOPHED should be titrated according to the response of the patient. Occasionally, much larger or even enormous daily doses may be necessary if patient remains hypotensive, but occult blood volume depletion should always be suspect and correct when present. Central venous pressure monitoring is usually helpful in detecting and treating this situation. Fluid Intake: degree of dilution depends on clinical fluid volume requirements. If large volumes of fluid are needed at a flow rate that would involve excessive dose of pressor agent per unit of time, solution more DILUTE than 4 mcg per mL should be USE. On the other hand, when large volumes of fluid are clinically undesirable, concentration greater than 4 mcg per mL may be necessary. Duration of Therapy: INFUSION should be continued until adequate Blood Pressure and tissue perfusion are maintained without Therapy. Infusions of LEVOPHED should be reduced gradually, avoiding abrupt withdrawal. In some reported cases of vascular collapse due to acute myocardial infarction, treatment was required FOR up to six days. Infusions of LEVOPHED are usually administered intravenously during cardiac resuscitation. To restore and maintain adequate blood pressure after effective heartbeat and ventilation have been established by other means. Average Dosage: To maintain systemic Blood Pressure during Management of cardiac arrest, LEVOPHED is used in the same manner as described under Restoration of Blood Pressure in Acute Hypotensive States.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Warnings

If your doctor has directed you to use this medication for your condition, your doctor or pharmacist may already be aware of any possible drug interactions or side effects and may be monitoring you for them. Do not start, stop, or change dosage of this medicine or any medicine before getting further information from your doctor, healthcare provider or pharmacist first. Isocarboxazid linezolid phenelzine procarbazine selegiline transdermal tranylcypromine norepinephrine has serious interactions with at least 34 different drugs. Norepinephrine has moderate interactions with at least 261 different drugs. Bendroflumethiazide bumetanide chlorothiazide chlorthalidone cyclopenthiazide desmopressin ethacrynic acid eucalyptus furosemide hydrochlorothiazide indapamide methyclothiazide metolazone noni juice sage torsemide in this document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist about all products you use. Keep a list of all your medications with you, and share list with your doctor and pharmacist. Check with your physician if you have health questions or concerns. Aantidote 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 a syringe with a fine hypodermic needle, with solution being infiltrated liberally throughout the area, which is easily identified by its cold, hard, pallid appearance. This medication contains norepinephrine. Do not take Levarterenol or Levophed if you are allergic to norepinephrine or any ingredients contained in this drug. Keep out of reach of children. In case of overdose, get medical help or contact the Poison Control Center immediately.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

DESCRIPTION

Norepinephrine is a sympathomimetic amine which differs from epinephrine by absence of methyl group on nitrogen atom. Levophed is - 3 4 - dihydroxybenzyl alcohol tartrate monohydrate and has the following structural formula: LEVOPHED is supplied in sterile aqueous solution in form of Bitartrate salt to be administered by intravenous infusion. Norepinephrine is sparingly soluble in water, very slightly soluble in alcohol and ether, and readily soluble in acids. Each mL contains 1 mg of norepinephrine base, Sodium Chloride for isotonicity, not more than 0. 2 mg or 2 mg of Sodium metabisulfite as an antioxidant, and may contain Sodium hydroxide and / or hydrochloric acid for pH adjustment to 3. 0 - 4. 5 air in containers has been displaced by nitrogen gas.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

SIDE EFFECTS

Norepinephrine is a vasopressor that is most appropriate for maintaining mean arterial pressure via an increase in systemic vascular resistance after or during appropriate fluid resuscitation. It has some beta activity, making it more suitable than pure alpha 1 agonists in many situations. However, it should still be used cautiously if a patient has poor cardiac function or pulmonary hypertension. Although use of this drug can be life - saving, improper monitoring can lead to malignant hypertension, arrhythmias, or tissue necrosis. Therefore, all members of the interprofessional care team should be highly alert and avoid compliance when utilizing this powerful medication. Clinicians will be prescribing this agent, but pharmacy should verify dosing and check for drug interactions, reporting any concerns to the team. Nursing will be performing administration, and be on the lookout for both systemic adverse effects of issues with administration itself, such as extravasation, and immediately alert clinicians on duty if they see anything noteworthy. The best and safest outcome will occur when critical care and emergency nurses work in concert with clinicians in monitoring patients on this medication for untoward events; interprofessional team approach is best to guide optimal therapeutic results.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

PRECAUTIONS

Infusion sites should be checked frequently for free flow. Care should be taken to avoid extravasation of LEVOPHED into tissues, as local necrosis might ensue due to vasoconstrictive action of the drug. Blanching along the course of infused vein, sometimes without obvious extravasation, has been attributed to vasa vasorum constriction with increased permeability of vein wall, permitting some leakage. This also may progress on rare occasions to superficial slough, particularly during infusion into leg veins in elderly patients or in those suffering from obliterative vascular disease. Hence, if blanching occurs, consideration should be given to the advisability of changing infusion site at intervals to allow the effects of local vasoconstriction to subside.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

CONTRAINDICATIONS

There are no absolute contraindications to administration of norepinephrine. As mentioned above, norepinephrine use may be contraindicate to treating hypotension that is likely secondary to cardiogenic mechanisms. Additionally, for hypotension primarily related to hypovolemia, norepinephrine is probably not the best agent. The Fda does state that its use could be consideration in low volume states, but only as an emergency measure for maintaining coronary or cerebral perfusion pressure while waiting for appropriate volume resuscitation. Generally, use of norepinephrine should be avoided in patients with mesenteric or peripheral vascular thrombosis as subsequent vasoconstriction will increase area of ischemia and infarction. Profound hypoxia or hypercarbia can sensitize the myocardium to unstable arrhythmias, which could be exacerbated or even be initiated by use of norepinephrine - this is also the case with specific anesthetic agents, such as halothane and cyclopropane. Levophed, preparation of norepinephrine, typically used in clinical setting, contains sodium metabisulfite, which may cause allergic reactions in susceptible individuals. This effect may be more common in asthmatics. Care is necessary when using norepinephrine concomitantly with monoamine oxidase inhibitors or amitriptyline and imipramine - type antidepressants. The combination of any of these drugs can lead to severe, prolonged hypertension.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Pre-Mixed Dopamine

Table

Cat. No.Size
D1442-60SS250 mL
D1482-60SS250 mL

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

The formulas of the active ingredients are:

IngredientsMolecular FormulaMolecular Weight
Hydrous Dextrose USP198.17
Dopamine Hydrochloride189.64
* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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