Corbadrine
Corbadrine, also known by its trade name Levophed, is a medication and sympathomimetic drug used primarily in the management of hypotension, particularly in cases where the heart is still functioning adequately. It is a synthetic amine that acts on both alpha-adrenergic and beta-adrenergic receptors, but its main mechanism of action is as an alpha-1 adrenergic receptor agonist, leading to vasoconstriction. This vasoconstriction increases blood pressure by increasing peripheral vascular resistance. Corbadrine is often used in critical care settings, such as intensive care units (ICUs), for patients experiencing acute hypotension or shock.
Medical Uses[edit | edit source]
Corbadrine is primarily used in the treatment of acute hypotension, especially when the condition is not responsive to fluid resuscitation alone. It is also used in certain cases of cardiogenic shock, where it helps to maintain blood pressure and organ perfusion without significantly increasing the heart's oxygen demand.
Mechanism of Action[edit | edit source]
Corbadrine acts by stimulating alpha-1 adrenergic receptors on vascular smooth muscle, leading to vasoconstriction and an increase in blood pressure. Its action on beta-adrenergic receptors is less pronounced but can lead to increased heart rate and cardiac output, which can also help in maintaining blood pressure and tissue perfusion in shock states.
Pharmacokinetics[edit | edit source]
The pharmacokinetics of Corbadrine involve rapid absorption and onset of action when administered intravenously, which is the common route in acute care settings. Its metabolism is primarily hepatic, and it is excreted in the urine. The half-life of Corbadrine is relatively short, necessitating continuous infusion to maintain therapeutic levels in critically ill patients.
Adverse Effects[edit | edit source]
The use of Corbadrine can be associated with several adverse effects due to its potent vasoconstrictive properties. These include hypertension, arrhythmia, anxiety, headache, and pulmonary edema. Its use requires careful monitoring of blood pressure, heart rate, and signs of organ perfusion.
Contraindications[edit | edit source]
Corbadrine is contraindicated in patients with hypertensive crisis, pheochromocytoma, and in those with hypersensitivity to sympathomimetic amines. Caution is advised in patients with coronary artery disease, as the increase in blood pressure can lead to an increase in myocardial oxygen demand.
Administration[edit | edit source]
In the clinical setting, Corbadrine is administered intravenously. The dose and rate of infusion are adjusted based on the patient's response, with the goal of maintaining adequate blood pressure and organ perfusion.
Conclusion[edit | edit source]
Corbadrine is a critical tool in the management of acute hypotension and shock, particularly in settings where rapid pharmacological intervention is necessary. Its use, however, requires careful monitoring and adjustment to avoid potential adverse effects and to ensure optimal patient outcomes.
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Contributors: Prab R. Tumpati, MD