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Mechanism of Action

Norepinephrine functions as a peripheral vasoconstrictor by acting on alpha-adrenergic receptors. It is also an inotropic stimulator of the heart and dilator of coronary arteries as a result of it's activity at the beta-adrenergic receptors.

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Nursing Responsibilities

Monitor blood pressure and apical pulse continously during norepinephrine therapy.

Cardiac monitor should be used on patients receiving norepinephrine IV infusions.

Defibrillator and resuscitation cart should be close by during infusion.

Titrate infusion rate to maintain systolic BP at 80 – 100 mg Hg.

Assess patient frequently for headache, chest pain, or other signs of toxicity.

Do not mix other medications in IV line with norepinephrine drip.

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Side Effects and Adverse Effects

Slow heart rate, High blood pressure (hypertension), Irregular heartbeats (arrhythmias), Confusion, Anxiety, Shortness of breath, with or without respiratory difficulty, Headache, Nausea and vomiting

Potentially Fatal: Pain or burning where the injection is given, Sudden numbness/weakness/cold feeling in your body, Blue lips or fingernails

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Contraindications

Patients that are hypersensitivity to the drug; Low blood pressure (hypotension) due to blood volume deficit and has Peripheral vascular thrombosis

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Indication/s

Mainly used to treat patients in vasodilatory shock states such as septic shock and neurogenic shock and has shown a survival benefit over dopamine. Also used as a vasopressor medication for patients with critical hypotension.

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Classification

Alpha/Beta Adrenergic Agonists

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Stock Dosage

Initial: 8-12 mcg/min IV infusion; titrate to effect
Maintenance: 2-4 mcg/min IV infusion

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Generic name: Norepinephrine Hydrochloride
Brand name: Levophed; Norepin

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Nursing Responsibilities

Always check compatibilities with other IV solutions.

Give deep subcutaneous injections; do not give heparin by IM injection.

Check for signs of bleeding; monitor blood tests.

Alert all health care providers of heparin use.

Have protamine sulfate (heparin antidote) readily available in case of overdose; each mg neutralizes 100 units of heparin.

Report nose bleed, bleeding of the gums, unusual bruising, black or tarry stools, cloudy or dark urine, abdominal or lower back pain, severe headache.

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Side Effects and Adverse Effects

Easy bleeding and bruising

Discomfort, redness, warmth, irritation, or skin changes where the drug was injected

Itching of your feet; or bluish-colored skin are all common Heparin side effects.

Heparin's adverse effects include thrombocytopenia, heparin-induced thrombocytopenia (HIT), and heparin-induced thrombocytopenia and thrombosis (HITT).

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Contraindications

Patients with hypersensitivity to the drug, past or present heparin-induced thrombocytopenia and active bleeding.

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Indication/s

​​Heparin sodium is used to treat the following conditions:

Treatment of consumptive coagulopathies (disseminated intravascular coagulation) in both acute and chronic forms.

Thrombosis prevention in vascular and cardiac surgery

Anticoagulant usage in blood transfusions, extracorporeal circulation, and dialysis treatments; prevention and treatment of peripheral artery embolism.

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Mechanism of Action

It produces its major anticoagulant effect by inactivating thrombin and activated factor X (factor Xa) through an antithrombin (AT)-dependent mechanism.

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Classification

Anticoagulants , Cardiovascular

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Dosages :

ADULTS
- Subcutaneous (deep subcutaneous injection)

For general anticoagulation: IV loading dose of 5,000 units and then 10,000–20,000 units subcutaneously followed by 8,000–10,000 units q 8 hr or 15,000–20,000 units q 12 hr.

IV

Intermittent IV: Initial dose of 10,000 units and then 5,000–10,000 units q 4–6 hr.

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Generic name: Heparin
Brand name: Hepalean (CAN)