N-Epi Contraindications

1) Norepinephrine is contraindicated in patients who are hypotensive due to blood volume deficit except during emergency to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed. If norepinephrine is continuously administered to maintain blood pressure in the absence of blood volume replacement, the following may occur: severe peripheral and visceral vasoconstriction, decreased renal perfusion and urine output, poor systemic blood flow despite "normal" blood pressure, tissue hypoxia and lactic acidosis.
2) Norepinephrine is contraindicated in patients with peripheral or mesenteric thrombosis due to the risk of increasing ischemia and extending the area of infarction, unless administration is necessary for a life-saving procedure.
3) Norepinephrine is contraindicated for use during cyclopropane and halothane anesthetics because of the risk of producing ventricular or tachycardia fibrillation.
4) Patients with profound hypoxia or hypercarbia can develop arrhythmias.