A sympathomimetic amine, Norepinephrine is a non-selective adrenergic receptor agonist, widely considered to be the first-line vasopressor for undifferentiated hypotension. It is similar to Epinephrine with broad-spectrum activity on α andβ receptors, but it has several unique features:
- It has strong affinity for α1 receptors, causing vasoconstriction, ↑PVR, and ↑afterload. Excellent choice for distributive or vasodilatory shock (such as sepsis).
- It has relatively weak affinity for β1 receptors (inotropy). Poor choice for cardiogenic shock (especially considering, ↑PVR, and ↑afterload).
- It has no α2 or β2 activity. Is ineffective against asthma or anaphylaxis
- It has consistent, predictable, and dose-independent receptor affinity & clinical effects.
Quick Overview
Adopted from Medzcool, YouTube, 2016
A Detailed Lesson
Adopted from ICU Advantage, YouTube, 2021
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