A potent alpha-adrenergic agent utilized in septic shock, but may decrease cardiac output, perfusion to vulnerable organs and oxygenization.
Norepinephrine levels are increased with reflect pharmacological norepinephrine transporter blockade by tricyclic antidepressants, and amphetamine like drugs such as methylphenidate.
Norepinephrine stimulates beta1- and alpha-adrenergic receptors, increasing cardiac muscle contractility and heart rate, as well as vasoconstriction; this results in systemic blood pressure and coronary blood flow increases.
After obtaining a response, the rate of flow should be adjusted and maintained at a low-normal blood pressure, such as 80-100 mm Hg systolic, sufficient to perfuse vital organs.