Which drug should be infused continuously?

Norepinephrine is a medication commonly used in the management of severe hypotension and shock. Infusing it continuously is vital due to its pharmacologic properties and the need for tight control over blood pressure. Norepinephrine acts as a potent vasopressor, increasing vascular resistance and thereby raising blood pressure when systemic vascular resistance is low.

Continuous infusion allows for a steady plasma concentration of the drug, which is crucial for maintaining consistent therapeutic effects without causing fluctuations in blood pressure, which can lead to complications. Rapid or bolus administration of norepinephrine could result in overshooting the desired blood pressure response, potentially causing harmful side effects.

In contrast, drugs such as vancomycin and gentamicin are typically administered intermittently. These antibiotics are often given in bolus doses rather than continuous infusions due to their pharmacokinetics and the need for reaching therapeutic drug levels while mitigating toxicity. Ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), is usually given as needed for pain relief and inflammation rather than through continuous infusion.

Thus, the practice of continuously infusing norepinephrine is based on its role as a vasopressor and the need for consistent hemodynamic support in critically ill patients.