Emergency Drugs · α₁ agonist (>β)
Noradrenaline (Norepinephrine)
Dose
Infusion 0.05–0.5 mcg/kg/min IV (titrate to MAP ≥65). Max 3 mcg/kg/min.
Mechanism
Potent α₁ → vasoconstriction; mild β₁ → ↑ contractility
Indications
- • Septic shock
- • Post-arrest
- • Neurogenic shock
Contraindications
- • Hypovolaemia uncorrected
Dilution & preparation
4 mg in 50 mL D5W = 80 mcg/mL (central) or 4 mg in 250 mL = 16 mcg/mL (peripheral, short-term)
Administration
Central line preferred; titrate per MAP
Use
First-line vasopressor in septic shock.
Monitoring
Arterial BP, MAP, urine output, lactate, peripheral perfusion, extravasation site.
Side effects
- • Peripheral ischaemia
- • Arrhythmias
- • Extravasation necrosis (give phentolamine 5–10 mg in 10 mL NS SC)
Pregnancy safety
Use if benefit > risk
Always confirm dose against your local formulary / BNF before prescribing.
