Background-During septic shock, the vasoconstrictor response to norepinephrine is seriously blunted. Animal experiments suggest that hyperpolarization of smooth muscle cells by opening of potassium (K) channels underlies this phenomenon. In the present study, we examined whether K-channel blockers and/or nitric oxide (NO) synthase inhibition could restore norepinephrine sensitivity during experimental human endotoxemia. Methods and Results-Volunteers received 2 ng/kg Escherichia coli endotoxin intravenously. Forearm blood flow (FBF) was measured with venous occlusion plethysmography. Infusion of 4 dose steps of norepinephrine into the brachial artery decreased the FBF ratio (ratio of FBF in the experimental arm to FBF in the control arm) to 84Ϯ4%, 70Ϯ4%, 55Ϯ4%, and 38Ϯ4% (meanϮSEM) of its baseline value. After endotoxin administration, norepinephrine-induced vasoconstriction was attenuated (FBF ratio, 101Ϯ4%, 92Ϯ4%, 83Ϯ6%, and 56Ϯ7%; nϭ30; Pϭ0.0018; pooled data). Intrabrachial infusion of the K-channel blocker tetraethylammonium (TEA) completely restored the vasoconstrictor response to norepinephrine from 104Ϯ5%, 93Ϯ7%, 93Ϯ12%, and 69Ϯ12% to 89Ϯ9%, 73Ϯ4%, 59Ϯ5%, and 46Ϯ8% (nϭ6; Pϭ0.045). Other K-channel blockers did not affect the response to norepinephrine. The NO synthase inhibitor N