Sunday, October 19, 2025

Norepinephrine

Norepinephrine is a potent **α₁ agonist** and moderate **β₁ agonist**, producing **powerful vasoconstriction** and modest inotropy. 

It is the **first-line vasopressor** in septic, cardiogenic, and post-cardiac bypass vasodilatory shock.

Dose **0.02–0.3 mcg/kg/min**, titrated to MAP 65–75 mmHg; always via central line; treat extravasation with **phentolamine.


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# 1) Receptor-level action → clinical effects


**Primary receptor activity:**


* **α₁ agonist (dominant):** intense arterial & venous vasoconstriction → ↑ SVR, ↑ MAP.

* **β₁ agonist (moderate):** ↑ contractility and heart rate *slightly* but offset by baroreflex-mediated bradycardia.

* **β₂ agonist (minimal):** clinically negligible.


**Net effects:**


* ↑ MAP primarily via **↑ SVR**.

* Slight ↑ myocardial contractility & CO in moderate doses (depends on preload).

* Reflex **bradycardia** common due to baroreceptor activation.

* Improves coronary and cerebral perfusion pressure.


**Clinical summary of effects:**


* **Vascular:** potent vasoconstrictor, preserves perfusion pressure.

* **Cardiac:** improves inotropy modestly; no direct chronotropy in intact baroreflex.

* **Renal/splanchnic:** vasoconstriction; at adequate MAP, **net renal perfusion improved** by higher pressure.

* **Metabolic:** can cause mild hyperglycaemia, hyperlactataemia (β-effect on metabolism).


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# 2) Vial strength, preparation & basic pharmacokinetics (+ disadvantages)


**Formulation:**


* Standard ampoule: **4 mg/4 mL (1 mg/mL)**.

* Common ICU dilution: **4 mg in 50 mL** → **80 mcg/mL** (1 mL/h = 1.33 mcg/min).


  * Alternative: **8 mg/50 mL** (160 mcg/mL) for central use.


**Pharmacokinetics:**


* **Onset:** <1 min.

* **Duration:** 1–2 min (terminated rapidly by reuptake/metabolism).

* **Metabolism:** MAO & COMT → inactive metabolites.

* **Half-life:** ~2.5 min.

* **Elimination:** renal excretion of metabolites.


**Disadvantages:**


* **Requires continuous infusion**, short half-life.

* **Peripheral extravasation → severe tissue necrosis.**

* Excessive vasoconstriction → impaired peripheral, mesenteric, or renal flow if MAP overshoot.

* **Arrhythmia risk** lower than dopamine, but possible with high doses.


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# 3) Practical dosing


## A. Anaesthesia / Post–cardiac bypass


**Indications:** hypotension due to vasodilation, vasoplegia, or low SVR after CPB, sepsis, or anaesthetic-induced vasodilation.


* **Starting dose:** **0.02–0.05 mcg/kg/min**.

* **Titrate up:** by 0.01–0.02 mcg/kg/min increments.

* **Typical range:** **0.02–0.3 mcg/kg/min** (occasionally higher in refractory vasoplegia).

* **Usual ICU practice:** aim for **MAP 65–75 mmHg** (individualised).


**Preparation examples (for 70 kg):**


* 70 × 0.1 mcg/kg/min = 7 mcg/min.

  Using 80 mcg/mL solution → rate = **5.25 mL/h.**


**Peripheral use (if emergency):**


* Use **max 15–20 min** only through **large antecubital vein**; monitor closely; change to central line ASAP.


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# 4) Special populations — dosing cautions


### Pregnancy


* Used for **maternal hypotension** during spinal/epidural anaesthesia; maintains **better fetal acid–base status** than phenylephrine (lower reflex bradycardia).

* Crosses placenta minimally; **safe in obstetric anaesthesia** when titrated carefully.


### Lactation


* Short t½ and poor oral absorption → minimal transfer risk.


### Hepatic impairment


* Metabolised widely (not dependent on hepatic clearance). No dose adjustment required; **titrate to effect**.


### Renal impairment


* Metabolite excretion renal but inactive; **safe**.

* Improves renal perfusion indirectly via better MAP.


### Obesity


* Dose by **ideal body weight** to avoid excessive pressor effect.


### Paediatrics


* **Starting:** 0.05 mcg/kg/min; titrate to 1–2 mcg/kg/min if required (specialist monitoring).


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# 5) Drug interactions (clinically key)


* **MAOIs:** marked pressor response → start at **1/10th** normal dose or avoid.

* **TCAs / SNRIs:** exaggerated BP response.

* **Halogenated volatiles (esp. halothane):** myocardial sensitisation → **ventricular arrhythmia risk.**

* **β-blockers:** may cause unopposed α-stimulation → **severe hypertension/bradycardia**.

* **Ergot alkaloids, oxytocin:** additive vasoconstriction.

* **Phosphodiesterase inhibitors (milrinone):** synergistic—useful combination for inodilator + vasopressor balance.

* **General anaesthetics / propofol:** counteract vasodilation; titrate slowly.


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# 6) Significant complications & management


| Complication                              | Mechanism / Features                       | Management                                                                                                                                     |

| ----------------------------------------- | ------------------------------------------ | ---------------------------------------------------------------------------------------------------------------------------------------------- |

| **Peripheral extravasation necrosis**     | α₁ vasoconstriction → ischaemia            | Stop infusion, leave cannula, **phentolamine 5–10 mg in 10–15 mL saline** infiltrated around site; warm compress; surgical review if necrosis. |

| **Digital/mesenteric ischaemia**          | Excess vasoconstriction                    | Lower dose, reassess MAP goal, switch/add inodilator.                                                                                          |

| **Arrhythmia (AF/VT)**                    | β₁ effect, usually in high dose or hypoxia | Correct electrolytes, reduce dose; antiarrhythmics as indicated.                                                                               |

| **Reflex bradycardia**                    | Baroreceptor response                      | Often mild; if MAP adequate, observe. Severe → **atropine/glycopyrrolate** if symptomatic.                                                     |

| **Metabolic acidosis / hyperlactataemia** | From high β-stimulation (non-hypoxic)      | Usually benign; evaluate perfusion if severe.                                                                                                  |


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