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Norepinephrine, also known as noradrenaline and sold under the brand name Levophed among others, is a medication used to treat people with very low blood pressure. [2] It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids . [ 3 ]
Droxidopa is a synthetic amino acid precursor which acts as a prodrug to the neurotransmitter norepinephrine (noradrenaline). [4] Hence, it acts as a non-selective agonist of the α-and β-adrenergic receptors. Unlike norepinephrine, but similarly to levodopa (L-DOPA), droxidopa is capable of crossing the protective blood–brain barrier (BBB). [4]
Drug titration is the process of adjusting the dose of a medication for the maximum benefit without adverse effects. [ 1 ] When a drug has a narrow therapeutic index , titration is especially important, because the range between the dose at which a drug is effective and the dose at which side effects occur is small. [ 2 ]
In pharmacokinetics, the rate of infusion (or dosing rate) refers not just to the rate at which a drug is administered, but the desired rate at which a drug should be administered to achieve a steady state of a fixed dose which has been demonstrated to be therapeutically effective. Abbreviations include K in, [1] K 0, [2] or R 0.
The Surviving Sepsis Campaign guidelines recommend the very early management of the sepsis focusing on the hour-1 bundle. This includes use of Vasopressin 0.03 units/minute as add-on to norepinephrine (NE) with intent of either raising the mean arterial pressure or decreasing the norepinephrine dosage (i.e. de-catecholaminization). [13]
Repeated administration of a medication is also different from single dosing, as many drugs have active metabolites that can build up in the body. [6] Patient variables such as sex, age, and organ function may also influence the effect of the drug on the system. These variables are rarely included in equianalgesic charts. [7] [3] [8]
Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein.The intravenous route of administration is commonly used for rehydration or to provide nutrients for those who cannot, or will not—due to reduced mental states or otherwise—consume food or water by mouth.
In clinical practice, this means that it takes 4 to 5 times the half-life for a drug's serum concentration to reach steady state after regular dosing is started, stopped, or the dose changed. So, for example, digoxin has a half-life (or t 1 / 2 ) of 24–36 h; this means that a change in the dose will take the best part of a week to ...