title: Ischemic Necrosis of Upper Lip, and All Fingers and Toes After Norepinephrine Use.
abstract: A 68-year-old woman with necrosis of total finger, toe, and upper lip was requested by department of internal medicine. She was diagnosed with septic shock and treated with norepinephrine 10 days ago. Norepinephrine is an often-used medicine for normalizing blood pressure in septic shock patients. Norepinephrine stimulates adrenergic receptors, causing vasoconstriction and the rise of blood pressure. These peripheral vasoconstrictions sometimes lead to ischemic changes in end organs. In this case report, the authors describe ischemic necrosis of the upper lip and all fingers and toes after norepinephrine use in a patient in the intensive care unit.
authors: Department of Plastic and Reconstructive Surgery, Medical School of Chonbuk National University, Jeonju, Korea.
authors: Jin Yong
authors: JY
authors: Shin
authors: Si-Gyun
authors: SG
authors: Roh
authors: Nae-Ho
authors: NH
authors: Lee
authors: Kyung-Moo
authors: KM
authors: Yang
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003422:Critical Care; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000139:chemically induced*; D008046:Lip / Q000098:blood supply*; D009336:Necrosis; D009638:Norepinephrine / Q000009:adverse effects*; D012772:Shock, Septic / Q000188:drug therapy; D014034:Toes / Q000098:blood supply*; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
chemical_list: D014662:Vasoconstrictor Agents; D009638:Norepinephrine