Nor%252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520epinephrine

# Norepinephrine ## Overview Norepinephrine is a vasopressor and inotropic agent that acts primarily on alpha-1 adrenergic receptors, causing vasoconstriction, and to a lesser extent on beta-1 adrenergic receptors, increasing cardiac output. It is a potent agent used to support blood pressure in severe hypotension. ## Primary Indications * Treatment of septic shock and other distributive shock states. * Management of severe hypotension unresponsive to fluid resuscitation. ## Adult Dosing * **Initial infusion rate:** 0.01 to 0.02 mcg/kg/minute. * **Titration:** Increase by 0.01 to 0.02 mcg/kg/minute every 5-15 minutes as needed to achieve target mean arterial pressure (MAP) of 65 mmHg or higher. * **Maximum infusion rate:** Typically 0.1 mcg/kg/minute, but may be higher in select cases per local protocol. ## Pediatric Dosing * **Initial infusion rate:** 0.05 to 0.1 mcg/kg/minute. * **Titration:** Adjust as needed to achieve target MAP