NCLEX-RNPharmacological and Parenteral TherapiesHard
A client is receiving a continuous IV infusion of norepinephrine (Levophed) for septic shock. The nurse notes extravasation at the IV site, with blanching and coolness of the surrounding skin. Which medication should the nurse anticipate administering subcutaneously as an antidote?
- AProtamine sulfate
- BNaloxone
- CPhentolamine
- DVitamin K
Show answer & explanationAnswer & explanation
Correct answer: C. Phentolamine
Norepinephrine is a potent vasoconstrictor. Extravasation can cause severe vasoconstriction, leading to tissue ischemia and necrosis. Phentolamine, an alpha-adrenergic blocker, is the antidote used to counteract the vasoconstrictive effects when infiltrated subcutaneously around the site of extravasation.
Why the other options are wrong
- A. Protamine sulfate is an antidote for heparin overdose.
- B. Naloxone is an opioid antagonist, used for opioid overdose.
- D. Vitamin K is an antidote for warfarin overdose.
Norepinephrine Extravasation Antidote
Norepinephrine (Levophed) is a vasopressor that can cause severe local vasoconstriction if it extravasates (leaks out of the vein) into surrounding tissues. Phentolamine, an alpha-adrenergic blocker, is the specific antidote administered subcutaneously to induce local vasodilation and prevent tissue necrosis.
- Norepinephrine is a vasoconstrictor.
- Extravasation causes tissue ischemia.
- Phentolamine is an alpha-blocker.
- Phentolamine reverses vasoconstriction.
Memory trick: Pressor leaks, phentolamine gets the blood flowing back!