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Related Concept Videos

Diabetic Neuropathy01:22

Diabetic Neuropathy

DefinitionDiabetic neuropathy is nerve damage caused by long-standing diabetes mellitus. It results directly from prolonged high blood sugar levels.PathophysiologyThe pathophysiology of diabetic neuropathy involves both metabolic and vascular disturbances triggered by chronic hyperglycemia.Metabolic injury: Elevated glucose levels activate the polyol pathway within nerve cells, leading to the accumulation of sorbitol and fructose. This increases oxidative stress, disrupts normal nerve...
Diabetic Foot Ulcer01:31

Diabetic Foot Ulcer

Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory neuropathy reduces pain perception,...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...

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Related Experiment Video

Updated: May 11, 2026

Novel Surgical Rodent Model for Studying Neuroma Pain Treatment Options using Targeted Muscle Reinnervation Through the Saphenous Nerve
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Bilateral toe necrosis resulting from norepinephrine bitartrate usage.

Richard Simman1, Laemthong Phavixay

  • 1Wright State University Boonshoft School of Medicine, Dayton, OH, USA.

Advances in Skin & Wound Care
|May 21, 2013
PubMed
Summary
This summary is machine-generated.

Acute limb ischemia, characterized by pain, ulcers, or gangrene, can stem from emboli, thrombosis, or trauma. A rare instance of toe necrosis caused by norepinephrine bitartrate (Levophed) administration is detailed.

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Area of Science:

  • Vascular Surgery
  • Pharmacology

Background:

  • Acute limb ischemia presents with symptoms including ischemic rest pain, ulcers, and gangrene.
  • Arterial occlusion is a common cause of acute limb ischemia, often resulting from emboli, thrombosis, or trauma.

Observation:

  • This case report details toe necrosis, a rare complication.
  • The necrosis was specifically linked to the administration of norepinephrine bitartrate (Levophed).

Findings:

  • Norepinephrine bitartrate (Levophed) can precipitate acute limb ischemia.
  • The vasoconstrictive properties of norepinephrine bitartrate may lead to critical reduction in distal perfusion, causing tissue necrosis.

Implications:

  • Clinicians should be aware of the potential for severe peripheral ischemia with norepinephrine bitartrate use.
  • Monitoring for signs of compromised circulation in extremities is crucial during treatment with this potent vasopressor.