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
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
Use
Monitoring
Side effects
- • Peripheral ischaemia
- • Arrhythmias
- • Extravasation necrosis (give phentolamine 5–10 mg in 10 mL NS SC)
Pregnancy safety
Related in WardRound
Noradrenaline dilution
Dilution · 4 mg / 50 mL D5W → 80 mcg/mL
Noradrenaline dose calculator
Dose · Septic shock; titrate to MAP ≥65
Shock
Protocol · Hypoperfusion / circulatory failure
Sepsis
Protocol · Sepsis Six within 1 hour
Cardiogenic Shock
Protocol · Pump failure
Massive Pulmonary Embolism
Protocol · Haemodynamic instability + suspected PE
Tricyclic Antidepressant Overdose
Protocol · QRS widening = give bicarbonate
Septic Shock
Protocol · Vasopressors + antibiotics + source control
Sepsis & Septic Shock (ED)
Topic · Emergency Medicine
β-Blocker Overdose
Topic · Toxicology
Calcium Channel Blocker Overdose
Topic · Toxicology
TCA Overdose
Topic · Toxicology
Always confirm dose against your local formulary / BNF before prescribing.
