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Blood pressure increases; pulse increases
26%
156/602
Blood pressure decreases; pulse decreases
2%
14/602
Blood pressure increases; pulse decreases
52%
311/602
Blood pressure decreases; pulse increases
13/602
Blood pressure increases; pulse remains unchanged
14%
82/602
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Norepinephrine is a sympathomimetic that has a higher affinity for alpha-1-mediated vasoconstriction than beta 2-mediated vasodilation, resulting in increased blood pressure with reflex bradycardia. Norepinephrine is an adrenergic agonist that works mainly on the alpha-1 receptor leading to increased peripheral vascular resistance and thus increased blood pressure. It is important to note that alpha-1 vasoconstriction trumps beta-2 vasodilation with this agent. One may acutely first see a pulse increase, but eventually, the increase in blood pressure triggers the baroreceptors resulting in a reflex bradycardia that is stronger than any beta-1-mediated tachycardia. Therefore, over time, norepinephrine administration will result in a net increase in blood pressure and decrease in pulse. Incorrect Answers: Answer 1: Acutely, norepinephrine will increase the pulse, but over several hours, pulse decreases because of reflex bradycardia. Answer 2: Blood pressure increases with norepinephrine administration due to alpha-1-mediated vasoconstriction. Answer 4: Blood pressure increases with norepinephrine administration due to alpha receptor-mediated vasoconstriction. Reflex tachycardia can be seen with vasodilators like nitrates. Answer 5: Pulse decreases because of reflex bradycardia. Bullet Summary: Norepinephrine is a sympathomimetic and causes mostly alpha-1-mediated vasoconstriction leading to an increase in blood pressure with reflex bradycardia over time.
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