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Norepinephrine is an adrenergic substance with a mixed α and β1 effect, though the alpha effect and vasoconstriction predominate clinically. For this reason, it was historically known as leave 'em dead, because this drug was used to maintain blood pressure by creating profound vasoconstriction, sometimes to the point of peripheral gangrene. Norepinephrine is now known to be useful a adjunct to maintain blood pressure in patients with vasodilation associated with sepsis. As with all potent vasoconstrictors, norepinephrine must be given into a central vein, since inadvertent extravasation from a peripheral vein can cause tissue necrosis and sloughing.